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Many hospitals cut back on infection-control efforts
Hospital-associated infections annually kill an estimated 100,000 people and add $20 billion to the nation's health care bill. The increasing prevalence of multidrug-resistant organisms, state infection reporting mandates and the looming threat of an influenza A(H1N1) pandemic have made the job of preventing infections and controlling their spread that much harder. But amid the worst recession in decades, hospitals are cutting back wherever they can, and infection-control professionals report that their departments are not being spared. Four in 10 infection control professionals, who now prefer to be called "infection preventionists," said they have seen staffing or resource cuts in the last 18 months, according to survey results released in June by the Assn. for Professionals in Infection Control & Epidemiology Inc. "We have made tremendous strides in infection prevention over the last few years," APIC CEO Kathy L. Warye said at a news conference. "Institutions are setting am [Read more]
New York physicians want possible Health Net deal scrutinized
After a news report indicated that New York City-based EmblemHealth was set to buy Health Net's business in the Northeast, the Medical Society of the State of New York sent letters to state regulators raising objections to the takeover. Citing an already-concentrated market where EmblemHealth's Group Health Inc. and HIP Health Plan of New York are already large players, medical society executives asked New York Attorney General Andrew M. Cuomo and Eric R. Dinallo, superintendent of the state insurance department, to "closely scrutinize" the deal, first reported May 28 by the Hartford Courant. EmblemHealth spokeswoman Ilene Margolin declined to comment on the potential purchase. Health Net spokeswoman Amy Sheyer said the company doesn't comment on market speculation. But she did say the company was still in the midst of its "strategic review," the company's term for its efforts to sell off business outside of California. Health Net, a for-profit, publicly traded company based near [Read more]
Drugmakers agree to reduce medication costs for seniors
Washington President Obama announced that a key Democratic lawmaker had made a deal with brand-name drug manufacturers to decrease seniors' drug spending by $80 billion over the decade, in part by reducing the amount that Medicare Part D enrollees are expected to pay during a gap in government coverage. Obama unveiled the agreement by the Pharmaceutical Research and Manufacturers of America at a June 22 White House event. It also featured Senate Finance Committee Chair Max Baucus (D, Mont.), who brokered the deal with PhRMA. Few of the specific details of the agreement were made immediately available after the announcement, but one major element will be additional assistance for seniors who fall in the Medicare drug benefit's "doughnut hole." This coverage gap occurs after initial government Part D subsidies run out and before a catastrophic benefit kicks in, during which time enrollees must pay all of their drug costs in addition to any monthly premiums. PhRMA has pledged to pro [Read more]
Medical debt increasingly cited as factor in bankruptcies
Nearly two-thirds of bankruptcies in early 2007 were due in part to medical debt -- an increase of more than 20% since 2001 -- according to a national study of more than 2,000 cases. Of those who filed for bankruptcy due in part to medical debt, 92% had debt of more than $5,000 or 10% of their income, according to "Medical Bankruptcy in the United States, 2007: Results of a National Study," published in the May 18 issue of the American Journal of Medicine. The study is based on questionnaires returned by 2,314 debtors, plus court records and phone interviews. The study is a follow-up to a similar 2001 analysis based on bankruptcy filings in five states. The earlier study found that medical problems contributed to at least 46.2% of bankruptcies in those states. The newer study -- which required larger debts to label a bankruptcy as medically related -- found that the bankruptcies of 62.1% of people who filed between Jan. 25 and April 11, 2007, were at least partly related to medic [Read more]
House health reform bill first to tackle Medicare physician pay
Washington -- Upcoming cuts to Medicare physician rates would be expunged and the payment formula replaced with a modified system under a national health system reform proposal offered by House Democrats. The plan, in the form of an 850-page discussion draft, was unveiled June 19 by the three House committees with primary jurisdiction over health care -- Energy and Commerce, Ways and Means, and Education and Labor. It would start by erasing required pay cuts that have accumulated under the existing Medicare physician payment formula, the sustainable growth rate formula. After wiping the budgetary slate clean in 2010 by establishing a new SGR baseline and giving physicians a cost-based update for the year, a new system would launch in 2011 that could allow for positive rate updates going forward. Physician rates are currently cut across the board when annual spending on doctor services exceeds a target growth rate based on the nation's gross domestic product. Under the new system, [Read more]
Hospital system tries letting patients read physicians' notes
Tom Delbanco, MD, conducted an experiment in the 1970s in which he asked patients to take their own notes during clinical visits and compare them to their physicians' notes. The experiment didn't last long, he said, because when patients asked other physicians for notes, "doctors thought the patients were crazy," he said. "They literally said, 'I am calling a psychiatrist.' " Now, more than 30 years later, Dr. Delbanco, an internist at Beth Israel Deaconess Medical Center in Boston and professor of general medicine and primary care at Harvard Medical School, is trying again. He is one of the leaders of an experiment at Beth Israel that allows patients unfettered access to their doctors' notes made in relation to their visits. The idea is to see how granting real-time access to clinical notes will change the dynamic between physicians and patients. "In spite of a lot of enthusiasm ... no one really knows what will happen," said Jan Walker, RN, an instructor of medicine at Harva [Read more]
Doctors, nurses getting A(H1N1)
More than 80 physicians, nurses and other health care workers had contracted influenza A(H1N1) by late June, according to the Centers for Disease Control and Prevention. An agency report on some of the infected workers revealed that about half were infected at work, and none had followed all of the CDC's recommended protective practices, which include the use of respirators, gloves and eye protection. There is no vaccine. The report in the June 19 Morbidity and Mortality Weekly Report focuses on infected health care personnel detected through May 13 (www.cdc.gov/mmwr/preview/mmwrhtml/mm5823a2.htm/). Among them were four physicians, five registered nurses and four nursing assistants. "This is a snapshot of what we knew up until that time," said Michael Bell, MD, associate director for infection control at the CDC, who spoke at a June 18 briefing. Since May 13, the number of infected individuals with some relationship to health care delivery has grown, and detailed informatio [Read more]
Medical homesteading: Moving forward with care coordination
At first, the Cranford Family Practice in Cranford, N.J., did not appear to be the most logical choice to be a pioneer of the patient-centered medical home concept. For starters, the single-physician practice did not have a very robust disease registry to track patients across care settings. It also had limited electronic communication with patients, and it did not regularly host group visits for patients with related diseases or illnesses. But by participating in a national demonstration project with 35 other small- and medium-sized family practices, family physician Robert Eidus, MD, helped his practice realize its potential to serve as a medical home by strengthening its resources. "For some practices, this was completely new," Dr. Eidus said. "But others had been working in this direction for many years, and this was a catalyst to keep moving in this direction and foster patient care." The demonstration was sponsored by TransforMED, a wholly owned, for-profit subsidiary of [Read more]
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