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Updated guidelines urge routine bone density tests
More women should undergo routine bone density tests, according to updated U.S. Preventive Services Task Force recommendations for osteoporosis screening published online Jan. 17 in the Annals of Internal Medicine. The revision expands recommended screening to women younger than 65 whose fracture risk is deemed equal to or greater than that of an average 65-year-old white woman, since white women are more prone to the disease than those of other ethnic groups. The task force has recommended routine screening for women 65 and older and high-risk patients 60 and older since 2002. But research showed that there are some post-menopausal women younger than 60 at similar risk for osteoporosis as their older peers, said Ned Calonge, MD, MPH, task force chair and president and chief executive officer of the Colorado Trust, a foundation aimed at improving health care access in Colorado. "That expansion is one thing we thought would be really important," said Dr. Calonge, a family and p [Read more]
Medicare Advantage bonuses could go to low-performing private plans
Washington -- An Obama administration plan to test rewarding Medicare private plans that achieve higher scores on outcome-based measures will pay bonuses to plans that otherwise would be considered poor performers, according to a Jan. 6 letter to the agency from the Medicare Payment Advisory Commission. MedPAC, which advises lawmakers and other federal officials on how to set Medicare pay rates, sent the letter to the Centers for Medicare & Medicaid Services in response to a November 2010 CMS rule outlining changes to the Medicare Advantage program. Although CMS did not invite comments on the quality bonus payment demonstration proposed in the rule, MedPAC members said they were sufficiently concerned about the initiative to bring it to the attention of the agency. Under the national health reform law, Medicare Advantage plans starting in 2012 will receive higher benchmark payments if they are rated at least four stars on a five-star scale based on the quality of the coverage the [Read more]
Unequal distribution of doctors hurts children's medical care
The nation's pediatricians and family physicians who care for young patients are clustered primarily in large cities, leaving many small communities devoid of doctors to care for their children, a new study says. In an analysis of where such physicians practice nationwide, researchers determined that there are enough doctors to care for U.S. children, if only they were more evenly distributed. "The evidence is very strong that we have an adequate physician work force for children," said pediatrician Scott A. Shipman, MD, MPH, lead study author and assistant professor at the Dartmouth Institute for Health Policy and Clinical Practice. "The [child] population isn't growing that much. The problem there really is maldistribution." The number of general pediatricians grew 51% to 38,981 between 1996 and 2006, and the number of family physicians increased 35% to 83,081. Meanwhile, the number of U.S. children grew by just 9% to 73.7 million, according to the study published in the Jan [Read more]
Hospitals can save $10 million a year with safety measures
Single-bed patient rooms, wider bathroom doors, ubiquitous hand-hygiene facilities and other hospital design elements add to the costs of construction but can pay for themselves within a few years, according to a series of journal articles published in January. A package of evidence-based elements such as single rooms with bigger windows and ceiling-mounted patient lifts would add about $30 million to the cost of building a 300-bed, $320 million hospital. But the design could save an estimated $10 million a year by shortening lengths of stay and cutting workers' compensation costs, said the lead article of a set essays in the January/February Hastings Center Report ( The journal is published by The Hastings Center, a Garrison, N.Y.-based bioethics think tank. Many previous studies have concluded that adding safety measures to hospital design can help prevent patient falls, infections and worker injuries, the artic [Read more]
Medicaid hospital stay rate grows faster than privately insured
The number of hospitalizations paid by Medicaid went up at a faster rate than those covered by private insurance, according to a statistical brief issued Jan. 19 by the Agency for Healthcare Research and Quality. And that was before the full force of the recession had hit. Researchers analyzed data from the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample, which includes information on 95% of hospital discharges. Hospital stays among those with private insurance grew from 13.4 million in 1997 to 14.1 million in 2008, an increase of 5%. The numbers for patients on Medicaid went up by 30%, from 5.6 million to 7.4 million, and hospitalizations among the uninsured expanded 27%, from 1.7 million to 2.1 million. Patients on Medicaid tended to stay in the hospital longer than those on private insurance or without coverage. Medicaid patients had an average length of stay of 4.3 days. The privately insured and uninsured stayed an average of 3.8 days. The report did [Read more]
Senate rejects health reform repeal
Washington -- The Senate, as expected, failed to adopt a House-passed repeal of the national health system reform law on Feb. 2 by a vote of 47-51. Senate Minority Leader Mitch McConnell (R, Ky.) offered the repeal as an amendment to a bill reauthorizing the Federal Aviation Administration. However, the repeal amendment did not receive the 60 votes required under Senate rules to overcome Democratic parliamentary objections based on the repeal's estimated budgetary impact. McConnell said the vote was a chance for Senate Democrats who supported the health reform law last year to reconsider their stance on it. "It's not every day that you can get a second chance on a big decision after you know all the facts." But no Democrats in the upper chamber voted in favor of repeal. Two Democrats were absent for the vote. However, the Senate voted 81-17 on a separate amendment, written by Sen. Debbie Stabenow (D, Mich.), to undo a tax reporting mandate in the health reform statute that man [Read more]
Minnesota insurer unveils doctors' ratings over their objections
Minnesota physicians are fighting an effort by the state's second-largest insurer to assign stars to doctors in its network listings based on quality and efficiency scores on its new Premium Designation program. Medica, based in Minnetonka, Minn., launched its ratings program Jan. 19 as planned, despite a request from the Minnesota Medical Assn. to delay and address what it said were errors and inaccuracies in the program. Medica has 1.6 million members in Minnesota, as well as in North Dakota, South Dakota and Wisconsin. The company said 96% of Minnesota physicians and other health care professionals are in its network. The Medica program uses a modified version of UnitedHealthcare's Premium Designation program, which United spokesman Daryl Richard said the company uses in 138 markets. United, which is based in Minnetonka as well, doesn't sell insurance in Minnesota because state law prohibits for-profit HMOs. Medica contracted with United to rate its network physicians, Medi [Read more]
Michigan health system paying doctors for their advice
Some doctors at a Detroit-area hospital will start being paid for advice on how to improve patient safety and satisfaction, as well as care quality and efficiency. St. John Macomb-Oakland-Hospital, Oakland Center in Madison Heights, Mich., in January signed a two-year management services agreement with the new Oakland Physician Professional Management Group. More than 50 physicians, out of the several hundred on the medical staff, are part of this group. Most are in private practice, and both specialists and primary care physicians are included. Those participating will be paid for their time working on various projects. The hospital sees the agreement as a means of achieving greater alignment with physicians, as well as meeting various quality and outcome goals, such as reducing bedsores and falls. "This is just another way to work with our physicians and to engage our medical staff," said Terry Hamilton, senior vice president of operations with St. John Providence Health Sys [Read more]
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