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Adult vaccination rate still too low
Not enough adults are receiving recommended vaccinations, and there has been little progress increasing coverage in recent years, according to the latest Centers for Disease Control and Prevention statistics. Significant improvement is needed to stem the negative health consequences of vaccine-preventable diseases among adults, said the Feb. 3 Morbidity and Mortality Weekly Report. "We can't give up," said Sandra Fryhofer, MD, American College of Physicians' liaison to the Advisory Committee on Immunization Practices. "Vaccinations are vital to our nation's health, and they save health care dollars over the long term." At least 45,000 American adults die each year of diseases that could be prevented by vaccines. By comparison, fewer than 1,000 Americans die of childhood diseases that are vaccine-preventable, the CDC says. The report examined 2010 data on six vaccines: pneumococcal, hepatitis A, hepatitis B, herpes zoster, human papillomavirus and tetanus antigen-containing [Read more]
Doctors urged to educate patients about sodium consumption
Primary care physicians should talk to patients about ways to lower their sodium intake by about a quarter teaspoon of salt each day, says a Centers for Disease Control and Prevention official. Such a reduction would prevent thousands of deaths from cardiovascular disease, hypertension and stroke a year and save billions in health care dollars, said Mary E. Cogswell, DrPH, a senior scientist in the Division for Heart Disease and Stroke Prevention in the CDC's National Center for Chronic Disease Prevention and Health Promotion. To achieve that goal, she encourages doctors to educate patients on the amount of sodium they need each day and the importance of checking sodium content on nutrition labels. She also recommends that physicians talk to patients about items that have high sodium levels. Ten types of food account for 44% of the dietary sodium that Americans consume each day, according to a study published in the Feb. 10 issue of the CDC's Morbidity and Mortality Weekly Rep [Read more]
Members of the Republican political party warn HHS about promoting \
Ten Republican senators have criticized the Obama administration for marketing Medicare preventive services as being free to patients. The GOP lawmakers said the Dept. of Health and Human Services\' use of the word \"free\" in promotional materials to patients is misleading because there is no such thing as a \"free lunch.\" The senators wrote HHS Secretary Kathleen Sebelius a letter Feb. 7 chiding the Centers for Medicare & Medicaid Services for hiding the true cost of these services in 2011. "While we generally support encouraging preventative care, we are alarmed that HHS and CMS are stating that screenings provided through Medicare, such as colorectal cancer screenings, prostate cancer screening, mammograms, Pap tests and pelvic exams, and smoking cessation counseling are free services,\" the letter states. For instance, the national payment amount for a pelvic exam was $36.69 in 2011. A colonoscopy for a patient who is not at high risk for colon cancer cost $395.83. The M [Read more]
Some doctors shield whole truth from patients, survey shows
A majority of physicians told a patient that his or her prognosis was more positive than the medical facts warranted within the previous year. More than a third say it is sometimes OK to shield significant medical errors from affected patients or hide financial relationships with pharmaceutical companies and device makers from patients. These are just a few of the areas in which at least some physicians say that always telling patients the whole story is not the right way to go, according to a nationwide survey of nearly 2,000 doctors across seven specialties in the February issue of Health Affairs. "Despite widespread acceptance of communication principles and commitments by professional organizations, substantial percentages of U.S. physicians did not completely endorse these precepts, and many reported behaving in ways that deviated from these norms," said the study. For example, 11% of physicians said they might sometimes tell a patient something untrue, and about the same [Read more]
CMS rejects California Medicaid co-pays
Federal health officials on Feb. 6 denied a request by California to charge a variety of co-payments to most of its Medicaid enrollees. The co-pays would have ranged from $3 for prescriptions filled at pharmacies to $100 for inpatient hospital stays. The state expected the co-pays to generate $600 billion beginning in October 2013, said Norman Williams, spokesman for the California Dept. of Health Care Services, the state's Medicaid agency. But the state cannot implement the co-pays under a demonstration waiver, as it requested in December 2011, according to a letter from Centers for Medicare and Medicaid Services acting Administrator Marilyn Tavenner to California's Medicaid agency. The co-pays are neither temporary nor targeted at a specific population, both of which are requirements in federal Medicaid law. California is examining its options, including administratively appealing the federal decision, Williams said. California Medical Assn. President James T. Hay, MD, ap [Read more]
Defensive medicine seeping into physician training, study says
Practicing defensive medicine to avoid medical liability lawsuits may not be a formal part of medical school curriculum, but it's still being taught to medical students and residents, a study shows. A survey of 202 fourth-year medical students and third-year residents at Northwestern University Feinberg School of Medicine in Chicago found that 94% of students and 96% of residents have seen examples of defensive medicine in their clinical training. Nearly two-thirds of students and three-quarters of residents said their attending physician implied that they take medical liability concerns into consideration when making clinical decisions. Nearly half of respondents said their attending directly instructed them to do so, says the study in the February Academic Medicine. Educators should reframe such conversations to focus on reducing liability risk by improving patient safety and communication, said Kevin O'Leary, MD, lead study author and associate professor and associate chief [Read more]
Major employers support flu shot requirement for health professionals
Many of the country's largest companies are telling hospitals to send a message to physicians and other health professionals who refuse influenza immunization: "You're fired." "Transmission of seasonal influenza between health care workers and patients is a significant patient and worker safety issue. Failure to prevent the transmission of seasonal flu between health care workers and patients also increases health costs," said Helen Darling, president and CEO of the National Business Group on Health, at a Feb. 2 news conference. The organization represents 340 U.S. companies, 68 of which are listed on the Fortune 500. Most hospitals that have adopted mandatory policies require all employees to receive the flu vaccination as a condition of employment unless they present evidence of a medical contraindication. If the employees do not get immunized, they are typically required to wear face masks whenever they interact with patients or risk getting a pink slip. "Requiring flu vacc [Read more]
CMS lays out how to appeal meaningful use decisions
The Center for Medicare & Medicaid Services' Office of Clinical Standards and Quality announced the establishment of a two-tier appeals process for physicians who were deemed ineligible for Medicare meaningful use incentive pay, or who thought their pay was too low. There are three types of appeals physicians can file: An eligibility appeal will allow doctors to show that all the requirements to earn an incentive payment were met, but payment was not received due to circumstances outside of his or her control. Eligibility appeals must be filed before March 30 to appeal decisions for payment year 2011. A meaningful use appeal allows physicians to show that they used a certified electronic medical record system and met all meaningful use objectives and measures. These appeals must be filed within 30 days of the physician receiving a demand letter or other finding from the review board. An incentive payment appeal allows physicians to show that they provided claims [Read more]
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