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Senate health reform bill pushed by Obama budget chief
The Senate health reform bill as introduced would set a more sustainable course for the American health system, although its success ULTIMATEly would depend on the effectiveness of its implementation, said Peter Orszag, PhD, director of the White House Office of Management and Budget. Orszag said the bill's proposed Medicare commission, tax on high-cost insurance plans and delivery system reforms -- including an emphasis on comparative effectiveness research -- are important provisions that would help control health spending and improve quality. Senators began debating the Patient Protection and Affordable Care Act on Nov. 30. "Too much of the health care services delivered in the United States are not backed by evidence that they work better than an alternative," he said at a Dec. 2 breakfast for Washington health care reporters sponsored by Health Affairs. "We need incentives for quality so that we can move toward a system that emphasizes making people better rather than have m [Read more]
Racial gap in preventive care found to increase hospitalizations
Patients with chronic conditions such as diabetes can avoid hospitalization with good primary care, medical experts say. But black patients with diabetes are hospitalized about five years earlier than are white diabetics, showing yet another area of health care delivery in which racial disparities seem to prevail. Researchers at Yale University in Connecticut examined a nationally representative sample of 6,815 hospital discharges from 2005 and found that the disparities persisted even after adjusting for gender, marital status, hospital region and payment type. "Racial disparities across nearly all health outcomes are well-documented -- from premature birth to premature death," said Jeanette R. Ickovics, PhD, director of the social and behavioral sciences program at the Yale University School of Public Health. "Our study adds perspective to one important aspect of health: premature hospitalization. Health inequity is a result, in part, of social, educational, economic and health [Read more]
Illinois doctor delivers air male
Thousands of feet above the ground, Illinois internist John Saran, MD, delivered a premature, 5-pound baby boy in the back of a Southwest Airlines Boeing 737. The doctor thought his flight was going to be the start of a quiet weekend with his wife, Janet, in the mountains overlooking Salt Lake City -- a getaway with no calls or pages from the office. Instead, Dr. Saran became an instant media sensation, appearing on morning talk shows and in newspapers throughout the country. "I've [responded to calls for a doctor] on planes, buses, cruise ships and in hotels for people with chest pain and stomach pain. ... But a lady in labor -- I never had to deal with that," said Dr. Saran, who has an internal medicine practice at Edward Hospital in Naperville, Ill., and is affiliated with MDVIP, a nationwide network of physicians who practice personalized preventive care. He was napping on the Dec. 4 flight when his wife poked him and said the woman in front of them was in labor. The pi [Read more]
Children with autism show considerable gains with early intervention
Children with autism spectrum disorder can see significant improvement in IQ, language and adaptive behavior when they receive comprehensive developmental behavioral intervention before age 2½, a new study shows. Young children who received this more intensive intervention on average increased their IQs 17.6 points after two years. Called the Early Start Denver Model, the therapy model involves parents and therapists working with children on improving communication, social skills and other skills. Sessions are provided in the child's home rather than in an office setting. Toddlers who received help commonly available in their communities, usually in an office setting without the more intense parental involvement, averaged a 7-point increase, according to the study published online Nov. 30 by Pediatrics (pediatrics.aappublications.org/cgi/content/abstract/peds.2009-0958v1/). "This is the first controlled study of an intensive early intervention that is appropriate for children [Read more]
Medicare now covers HIV tests
The Centers for Medicare & Medicaid Services announced Dec. 8 that Medicare will cover HIV screening services, effective immediately. Testing will be covered for Medicare beneficiaries who are at increased risk for HIV, as well as for those who request the service. Under the Medicare Improvements for Patients and Providers Act of 2008, lawmakers gave CMS the flexibility to add to Medicare's list of covered preventive services. Before MIPPA, Medicare could cover additional screenings only when Congress authorized it to do so. According to the Kaiser Family Foundation, the number of Medicare beneficiaries with HIV increased by 80% between 1997 and 2003, from 42,520 to 76,500. In fiscal year 2008, Medicare spending on HIV totaled $4.5 billion, representing 39% of federal spending on HIV care. The decision was hailed as a milestone by Health and Human Services Secretary Kathleen Sebelius. "Beginning with expanding coverage for HIV screening, we can now work proactively as a pro [Read more]
Senate approves sweeping health reform bill, 60-39
The Senate approved comprehensive health system reform legislation by a strict party-line vote of 60-39 during a rare Christmas Eve session. Passage of the Patient Protection and Affordable Care Act was assured the previous day when the Senate moved to end debate and proceed to a final vote, the last of a series of procedural motions that required 60 votes to proceed. The legislation now goes to a conference committee, where lawmakers will try to negotiate a consensus bill between the Senate measure and a much different House version that passed by a vote of 220-215 on Nov. 7. "Today, the Senate took an historic vote to improve our nation's health care system by expanding coverage to millions of Americans and strengthening the private insurance market to better serve the patients who rely on it," American Medical Association President J. James Rohack, MD, said in a statement. "The AMA supported passage of the bill because it contains a number of key improvements for our health ca [Read more]
Mississippi program aims to keep diabetics out of the hospital
The Centers for Medicare & Medicaid Services announced on Oct. 29 a new statewide effort in Mississippi to improve care for patients with diabetes. As part of the initiative, called the Mississippi Health First Collaborative, patients will receive diabetes self-management training in their home communities. The assistance will occur in locations such as community centers or senior centers, rather than in such traditional health care settings as hospitals, physicians' offices or outpatient clinics. The training will focus on how best to control blood glucose, blood pressure and cholesterol levels. CMS is contacting community groups, health experts, housing providers, health care professionals and community leaders to reach out to patients across the state, including Medicare and Medicaid beneficiaries, those with private insurance, and the uninsured. The professionals also will help patients establish relationships with primary care physicians, address better nutrition, and develo [Read more]
Patient safety surveillance: keeping watch in hospitals, from sinks to surgery
Doctors in Maryland hospitals soon may find themselves the targets of covert surveillance. That stranger in the corridor reading Newsweek or texting on his iPhone actually may be taking notes on whether physicians and other health care workers wash their hands after leaving patients' rooms. In early November, the state launched a safety initiative using $100,000 in American Recovery and Reinvestment Act -- popularly known as the federal stimulus package -- funds to help hospitals train "secret shoppers" to monitor health workers' hand hygiene. Forty-five of the state's 47 acute care hospitals have joined the voluntary initiative. The Maryland effort is believed to be the first time that government funds are going to train secret observers to keep an eye on doctors. At the same time, Rhode Island health officials have ordered video monitoring of surgeries at one hospital after a rash of wrong-site surgical errors. Hospitals increasingly are turning to these surveillance meth [Read more]
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