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Health industry consolidation raising prices, lawmakers say
Washington -- Rapid consolidation in the health care industry has a key panel of lawmakers examining federal antitrust laws and physician payment models. The House Ways and Means health subcommittee held a Sept. 9 hearing to gather testimony on the impact of hospitals acquiring physician practices and insurers dominating community health care market shares. Lawmakers said these developments have caused higher prices and increased spending on health care by patients, businesses and governments. Rep. Wally Herger (R, Calif.), the subcommittee's chair, pointed to research showing that when hospitals merge, the prices charged to insurance companies increase. But consolidation does not necessarily lead to greater efficiency and improved quality of care, he said. "When hospitals purchase physician groups, hospitals are able to further increase revenue by controlling referral patterns and creating a situation in which they could pressure their physicians to perform more procedures," [Read more]
Diabetes risk increases with duration of obesity
Research has long shown that obesity might increase an individual's risk of developing type 2 diabetes. But a new study encourages health professionals to assess how overweight the individual is and how long he or she has been obese to get a more accurate idea of the person's diabetes risk. Authors of the study, published online Sept. 5 in the Archives of Pediatrics and Adolescent Medicine, compared the relationship between excess weight and developing type 2 diabetes with the link between smoking and the risk of lung cancer. "The amount of excess weight that you carry, and the number of years for which you carry it, dramatically increases your risk of diabetes," said lead study author Joyce M. Lee, MD, MPH, assistant professor in the division of pediatric endocrinology at the University of Michigan Health System. Dr. Lee recommends that physicians, particularly pediatricians and family physicians, help their young, overweight patients shed pounds to prevent them from becoming [Read more]
GOP bill would exempt all plans from health reform
Washington -- A bill drafted by House Republicans would exempt more health insurance plans from regulations under the health system reform law. GOP lawmakers discussed legislation to block the Dept. of Health and Human Services from enforcing reform law provisions during a Sept. 15 Energy and Commerce health subcommittee hearing. A draft version of the bill circulated during the hearing would grant grandfathered status to all health plans operating before the reform law was enacted on March 23, 2010. Such legislation would prevent HHS from implementing new mandates regarding coverage and health plan administration, said Rep. Joseph Pitts (R, Pa.), the subcommittee's chair. "That way, consumers who really do like the coverage they have really get to keep it." Rep. Frank Pallone Jr. (D, N.J.) disputed the notion that Americans have lost insurance coverage they enjoyed before the enactment of the reform law. The Republican proposal is just a ploy to repeal the statute, he said. [Read more]
Even brief explanations help patients make better medication decisions
Patients can choose safer, more effective medications if they are told about a drug's harms and benefits and they understand that newer doesn't always mean better when it comes to prescription drugs, a study says. The study in the Sept. 12 Archives of Internal Medicine involved an Internet-based randomized trial of about 3,000 people. Thirty-nine percent of respondents believed that the Food and Drug Administration approves only "extremely effective" drugs, and 25% believed the FDA approves only drugs without serious side effects. Participants made better choices about medications when they were given explanations about the drugs. For example, after a 23-word explanation about a drug's benefits and unknowns, 12% more people correctly chose a drug that reduced myocardial infarctions over one known to improve only cholesterol levels. A 37-word explanation about new drug safety led to 19% more people correctly choosing a heartburn drug with a longer track record, the study found. [Read more]
Illinois doctors need Medicaid preapproval for 17 mental health drugs
Illinois budget woes have led the state's Medicaid agency to place an administrative hurdle in front of physicians seeking coverage for certain medications to treat depression, psychosis, attention-deficit/hyperactivity disorder and other illnesses. Patient advocates say the barrier is affecting care. Beginning in May, the Illinois Dept. of Healthcare and Family Services excluded 17 drugs from its preferred drug list, meaning that physicians who wish to prescribe these medications must call or fax to obtain a coverage preauthorization. The list of drugs moved to the nonpreferred list includes relatively new treatments such as aripiprazole, also known by the brand name Abilify. The Medicaid agency expects that the change will save the state $90 million in its first year. The agency spends nearly $180 million a year on atypical antipsychotics -- the department's most expensive drug class. The four classes -- anticonvulsants, antidepressants, ADHD agents and atypical antipsychotics [Read more]
Number of physician assistants doubles over past decade
The number of physician assistants has grown dramatically as well as the number working in specialty care, according to an annual census report issued Sept. 8 by the American Academy of Physician Assistants. "There's a true increase in demand from all sectors of the health care community recognizing the value of the physician assistant as part of the team," said Michael Powe, AAPA's vice president of reimbursement and professional advocacy. A total of 40,469 physician assistants were practicing in 2000. The number grew to 83,466 in 2010. Other surveys also have noted that physician assistants, along with nurse practitioners and certified nurse midwives, have become common in medicine. A data brief issued Aug. 17 by the Centers for Disease Control and Prevention's National Center for Health Statistics found that 49% of physicians worked with the allied practitioners. Experts say the shift is a result of changing payment patterns. Payment of physician assistant services is mo [Read more]
Part-time surgeons would help ease shortage
Employing more part-timers may help reduce the nation's surgeon shortage by 2030, says a study in the September issue of the Journal of American College of Surgeons. Allowing surgeons to work part time would encourage them to remain in practice longer and help them achieve a better work-life balance, the study said. "Let's look at what we can do to keep people we are losing," said lead study author Bhagwan Satiani, MD, a vascular surgeon and professor of surgery at The Ohio State University Medical Center. He works part time as a surgeon. "This opens the door for people to stay in practice. ... People who have a balanced lifestyle are going to have a lower burnout rate." Dr. Satiani and his colleagues used a 2005 work force baseline of 99,000 surgeons in various specialties and estimated that 3,635 board certificates are granted each year. They said the average surgeon practices 30 years, with 3,300 retiring each year. They analyzed what would happen if one quarter, half or [Read more]
GAO urges Medicare to seek physician input on feedback reports
Washington -- A congressional watchdog group said more needs to be done to engage physicians before the government begins setting Medicare payments based on physician performance and quality of care. Federal statute requires the Centers for Medicare & Medicaid Services to send feedback reports analyzing the amount of Medicare spending incurred by individual physicians and comparing the resources used against those utilized by their peers. Starting in 2015, CMS will pay some physicians and medical groups based on information in this feedback program. All physicians will be subject to a "value-based payment modifier" starting in 2017. A Government Accountability Office report released in August was critical of CMS' work on the feedback program to date. CMS created feedback reports for a small percentage of physicians during the initial phases of the program, but a large number of those doctors failed to access the information. "CMS will need to do more to solicit input and react [Read more]
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