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CMS boosts funding for Medicare assistance
The Centers for Medicare & Medicaid Services has distributed more than $40 million to State Health Insurance Assistance Programs to help Medicare beneficiaries obtain more information about their benefits choices. The funding was made available on April 1 to the 54 SHIPs in the U.S. and its territories and is intended to assist people with limited incomes, beneficiaries with disabilities, and members of diverse racial and ethnic groups, CMS said. Earlier this year, the agency said it would dole out SHIP grant awards, but it did not specify how much each state would receive until the April 5 announcement. States receiving the largest amounts are California ($3.56 million), Florida ($2.72 million), New York ($2.31 million) and Texas ($2.30 million). CMS noted that, in applying for the grants, several SHIPs presented plans for expanding outreach activities to impact more American Indian and Hispanic populations. "Over the past 20 years, the faces of our Medicare beneficiaries [Read more]
Advance care planning focus of awareness campaign
Only a third of patients have living wills, and fewer than half of patients who have severe or terminal illnesses have advance directives, according to the Agency for Healthcare Research and Quality. More than 850 hospitals, hospices, law firms and other organizations around the country are hoping to change that April 16 by participating in the third annual National Healthcare Decisions Day. The event is designed to raise awareness about the need for advance care planning and make it easier for patients to make their wishes known. More than a quarter of dying patients lack the capacity to make end-of-life care decisions, says a study in the April 1 New England Journal of Medicine (content.nejm.org/cgi/content/short/362/13/1211/). For the two-thirds of patients who planned in advance -- completing a living will or appointing a durable power of attorney -- most received care consistent with their wishes, according to the study, which looked at 3,746 patients from 2000 to 2006. N [Read more]
More health IT help coming for primary care
The Dept. of Health and Human Services announced April 6 that it was awarding another $267 million to help physicians and hospitals accelerate their adoption of health information technology. The money is going to 28 nonprofit organizations that will run health IT regional extension centers, which are designed to provide outreach and technical support services largely to primary care practices and facilities. Earlier this year, HHS announced that more than $375 million had been awarded to 32 nonprofits to establish RECs. The centers provide a local resource for on-site technical assistance, guidance and information on health IT best practices. Officials overseeing the program have said they should be helpful particularly to smaller physician offices that may not have the resources available to larger practices or hospitals. All 60 REC awardees also have an opportunity to apply for a two-year extension supplemental award, which would ensure that health IT assistance services ar [Read more]
Interpreter services offered at more than half of physician practices
Physician practices are making some strides in reducing the cultural and linguistic barriers facing patients whose English proficiency is limited, but those efforts are "modest and uneven," according to a report released in February. Of practices that have non-English speaking patients, 55.8% provide interpreter services, said the report, based on a survey of 4,700 physicians nationwide and issued by the nonprofit Center for Studying Health System Change (hschange.org/CONTENT/1113/). Forty percent of practices provide patient-education materials in languages other than English, and four in 10 doctors have received cultural competency training aimed at helping them better serve minority populations. Less than a quarter of physicians receive reports about the demographic characteristics of their patients, and 7% routinely access electronic information about their patients' preferred language. More than 20 million patients speak limited English, according to a 2006 American Medic [Read more]
Per capita spending for immigrant health care far less than for U.S. citizens
Annual health spending on noncitizen immigrants is about half the spending on native U.S. citizens, largely because many noncitizens lack jobs with health insurance and are ineligible for most public coverage, according to "Trends in Health Care Spending for Immigrants in the United States," published in the March Health Affairs. Average per-person health care spending for noncitizens was $1,904 in 2006, compared with $3,723 for citizens, according to the study. Public spending on noncitizens also was relatively low. Between 1999 and 2006, it averaged $780 annually for noncitizens and $1,200 for U.S. natives, the article concluded. "There's a reluctance to use a lot of services on the part of noncitizens," said Eric Rodriguez, a vice president at the National Council of La Raza, a Hispanic civil rights and advocacy group. Rodriguez said the article's numbers are fairly consistent with estimates in other studies. Although immigrants do not receive disproportionate amounts of he [Read more]
National Practitioner Data Bank expanded
A new federal rule has expanded the scope of the National Practitioner Data Bank to include disciplinary information not just on physicians but on all licensed health care professionals. In an effort to promote patient safety, the confidential reporting system was established under the federal Health Care Quality and Improvement Act of 1986 to give hospitals a snapshot of any issues with a doctor's competence or conduct before credentialing. A final rule published Jan. 28 by the Dept. of Health and Human Services expanded the data reported to the Health Resources and Services Administration, which administers the data bank, to include adverse actions taken against licensed health care professionals. That includes nurses, chiropractors, podiatrists and physician assistants. The rule, published in the Federal Register, is available online (edocket.access.gpo.gov/2010/pdf/2010-1514.pdf). Before the new rule, the data bank collected negative findings only against physicians and de [Read more]
TV medical dramas misleading on seizure first aid
About half the time, the doctors and nurses on popular fictional TV medical shows give improper seizure first aid that, in reality, could lead to broken teeth, bruises or dislocations, according to a study to be presented in April at the American Academy of Neurology's annual meeting. Epileptologists noticed a trend of "people doing very inappropriate things on television and seeing some of the same sorts of things happening to our patients in real life," said Dr. Jeremy Moeller, who co-authored the study. "It's impossible to definitively prove the connection, but one of the potential sources of misinformation is TV." For example, bystanders should not try to hold down someone experiencing a generalized tonic-clonic, or grand mal, seizure, nor attempt to force open the patient's mouth, said Dr. Moeller, a postdoctoral clinical fellow at the Comprehensive Epilepsy Center in the Columbia University Medical Center Dept. of Neurology in New York. Dr. Moeller and his colleagues exa [Read more]
Hypertension seen as neglected disease
Hypertension ranks among the nation's leading causes of death, spurred largely by economic barriers to blood pressure medication, excessive sodium intake and inadequate consumption of potassium, a new study says. The Institute of Medicine report, released Feb. 22, also found that physicians don't always adhere to screening and treatment guidelines. The problem is not physician awareness or agreement with the guidelines but the challenge of preventing and treating hypertension, said internist Vincenza Snow, MD, director of clinical programs and quality of care for the American College of Physicians. Elderly patients, for example, often choose not to aggressively pursue control of hypertension. Guidelines also do not account for external factors, such as uninsured patients who can't afford medication and patients with comorbidities, she said. Guidelines call for periodic screening, with initiation of treatment if systolic blood pressure is greater than 140 mmHg or diastolic is g [Read more]
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