Medicine & Health articles from June 2007

Medicine & Health archives from June 2007

Health insurers maintain a competitive edge by expanding palliative-care coverage; an aging population increases the need for end of life care--are insurers prepared?(Palliative Care)
June 4, 2007... The steadily growing elderly population shows health-care providers and insurers alike that they need to put emphasis on a different kind of care--palliative, or comfort care. And many of the bigger insurers have taken notice to this increased...

Part D formularies could look a lot different in 2008; keep a close eye on these 3 Part D policy shifts.(Medicare Part D)
June 4, 2007... The feds have issued their final directive on Part D updates for 2008, but a close reading of the final call letter released April 19 suggests that the only thing certain about Part D as it evolves is uncertainty. Industry leaders are...

October through December could be physicians' cash-losing months; a half-dozen mistakes per week could spell $25,000 revenue drain.(Physicians)
June 4, 2007... Times are getting tougher for physician practices. If a physician practice is just missing five minor services per week, that could add up to huge losses, say experts. "Five mistakes a week," says Catherine Brink, president of Healthcare...

Report provides backing to link between happiness and good health; and resistance-training programs could be key to lowering seniors' diabetes risk.(Mental Health)
June 4, 2007... Two million adults age 65 and older experience depression, and a new study has linked the depression symptoms to diabetes. According to a recent report in the Archives of Internal Medicine, seniors who experience depressive symptoms that...

Fitness-discount programs successfully lower healthcare costs; bonus: Highmark BCBS kick-starts PHRs for its members.(Health Plans)
June 4, 2007... Blue Cross Blue Shield of Minnesota has found that fitness-center discounts work at getting its beneficiaries to join gyms, and that the regular gym memberships result in lower health-care costs. The keys to getting members to enroll in...

Problem: current AD drugs stop the production of a bad and a good protein; new drug promises no side effects for Alzheimer's patients.(Prescription Drugs)
June 4, 2007... Patients with Alzheimer's disease have no choice other than to deal with the negative side effects of the drugs currently on the market--but an improvement may be on the way. Researchers at Rockefeller University have discovered that...

Providers can use UPINs for referring physicians until may 2008; physicians can start testing their PQRI-claims submissions now.(Physician Notes)
June 4, 2007... At last, the requirements for the National Provider Identifier are getting clearer. Providers should already have their own NPIs, officials from the Centers for Medicare & Medicaid Services told a May 10 special open door forum on NPI...

Seniors use 'disproportionately high rate' of emergency medical services: EMS systems, staff should prepare for rising volume.(Data & Statistics)
June 4, 2007... It may come as no surprise that adults age 65 and older are more likely to require emergency medical services. But a new study emphasizes that fact by stating older adults have an EMS utilization rate four times that of younger patients. ...

Acute rehabs: take a look at early upright mobilization: plus: comparing finger tracking versus simple movement training post-stroke.(Clinical Rehab Studies)(Clinical report)
June 4, 2007... "The quantity of early upright mobilization performed following upper abdominal surgery is low: an observational study." Browning L, Denehy L, Scholes RL. Aust J Physiother. 2007; 53(1): 47-52. Researchers sought to study how much upright...

U.S. still lags behind other nations in health care quality: more obesity, diabetes in America, study finds.(Policy)
June 11, 2007... Though the United States has the most costly health-care system in the world, it still underperforms compared to peer nations, a Commonwealth Fund report reveals. In the 2007 edition of "Mirror, Mirror on the Wall: An International Update...

Researchers aren't rejoicing too fast at good news on disabilities; seniors gain from new technology, improved health care.(Disability)
June 11, 2007... Surprisingly, the percentage of older Americans with disabilities has actually decreased in the past 20 years. That's the one piece of good news in a new report on "The Future of Disability" from the Institute of Medicine. The report results...

Many hospitalizations for COPD and pneumonia are avoidable; experienced physicians are the hey to keeping patients out of the hospital.(Data & Statistics)
June 11, 2007... Bacterial pneumonia and chronic obstructive pulmonary disease are the third and fifth most common reasons for hospitalization among Medicare patients age 65 and older. But high-quality outpatient management could help to prevent some of these...

IRS wants to increase employer contributions to employee HSAs: bonus: new health-care model could save patients and insurers big bucks.(Managed Care)
June 11, 2007... More individuals may start opting for health savings accounts, with the Internal Revenue Service's new proposal to accelerate employer contributions, reports Business Insurance. Under this new proposal, employers would be allowed to speed...

More audits of doctors' debridement services are imminent; OIG finds millions of dollars in improper payments.(Physicians)
June 11, 2007... Nearly two-thirds of surgical debridement services didn't meet Medicare requirements in 2004. This cost the program approximately $64 million in improper payments, according to a new report from the HHS Office of Inspector General. ...

HHS pushes 3 new electronic-prescribing standards under part D: results from pilot projects are in.(E-Prescribing)
June 11, 2007... Pharmacists are keeping electronic prescribing on their Part D radar screen so they won't fall behind the times--and behind the competition. The Centers for Medicare & Medicaid Services and Congress are among the powerhouses pushing...

What e-standards will--and won't--do for pharmacists, others: the feds' test flight of related standards provides a few insights.(Technology)
June 11, 2007... The goal of the government's five pilot projects on e-prescribing was to explore how the proposed standards worked--or didn't work--in a variety of practice settings, across a number of geographic areas, and using several different...

Future finances for Part D could be rocky, report warns: plus: physician-payment cuts may force doctors to drop Medicare patients.(Industry Notes)
June 11, 2007... Medicare Part D may be succeeding so far in the government's eyes, but the program may not be easy to sustain, researchers say. A new report from the Henry J. Kaiser Family Foundation suggests that creeping costs could soon create major...

Six out of 10 physicians will have to limit the number of new Medicare patients.(In Other News ...)
June 11, 2007... * Six out of 10 physicians will have to limit the number of new Medicare patients they see if a 10-percent cut hits their Medicare payments next year, according to a new survey from the AMA.

American College of Physicians.(In Other News ...)
June 11, 2007... The American College of Physicians endorsed the High-Need Physician Workforce Incentives Act of 2007, which would create incentives for doctors to come into primary care and other generalist fields. The bill would create a scholarship program...

Genetics have a growing role in the health insurance industry: find out why compliance might not be health plans' biggest worry.(Legislation)
June 18, 2007... Many experts believe that the Genetic Nondiscrimination Act of 2007 (GINA) will pass; with the Act, the Food and Drug Administration is recommending genetic testing before prescription of certain drugs. Experts believe that by 2009, the...

Part D takes on more costs for vaccines: PDPs will cover administration in 2008.(Vaccines)
June 18, 2007... Recently released guidance from the Centers for Medicare & Medicaid Services outlines changes in Medicare reimbursement for vaccinations, shifting some costs covered under Medicare Part B to Part D starting next year. Called for by law,...

EEG may signal early Alzheimer's warning; non-invasive test could be performed easily at family physician's office.(Testing & Diagnoses)
June 18, 2007... An early diagnosis makes all the difference for slowing the progress of Alzheimer's disease, but research hospitals are currently the only facilities able to make a definitive diagnosis. A $1.1-million study, funded by the National...

Arizona House shoots down med mal bill; but tort reform legislation in North Carolina is moving forward.(Medical Malpractice)
June 18, 2007... Plaintiffs' attorneys in Arizona can breathe a sigh of relief--especially those with cases against emergency room physicians. After a narrow passage in the state Senate, the Arizona House killed legislation that would have made it harder...

Fair pay for generics a hot topic this summer, as new report fuels debate; state Medicaid directors join fight against the feds' attempt to slash Medicaid rates for genetic drugs.(Prescription Drugs)
June 18, 2007... States are reluctant to move too quickly in basing reimbursement on Average Manufacturer Price data, a new report released by the HHS Office of Inspector General reveals. The plan to cut Medicaid rates for generic prescription drugs stems...

The Highmark-Independence merger: good for competition or waiting to destroy small insurers? And why insurers aren't the only ones who should be concerned.(Mergers & Acquisitions)
June 18, 2007... On March 28, 2007, Pennsylvania health insurers Highmark and Independence Blue Cross dropped a bomb on the managed-care industry. They announced their merger, creating the largest insurer in the nation and engulfing more than half of the health...

Medicare part a trust fund has an extra year to live; seniors could get a bit more breathing room.(Medicare)
June 18, 2007... Medicare's Hospital Insurance Trust Fund will be exhausted in 2019, one year later than estimated last year, according to the Medicare Trustees Report issued April 23. But despite the improvement, the trustees still issued a "Medicare funding...

Physician NPI directory scheduled at last.(Industry Notes)(Directory)
June 18, 2007... Physicians finally have a date that they can expect a National Provider Identifier directory for referring physicians' NPIs. The Centers for Medicare & Medicaid Services will issue the NPI information June 28 as drawn from National Plan and...

P4P has little effect on how hospitals care for patients.(Industry Notes)
June 18, 2007... Medicare planners say financial incentives can prompt hospitals to improve their care efficiency and quality, but a recent Medicare-agency pilot project suggests otherwise, as the Wall Street Journal reports. A study that researchers at...

How NPs could save money without sacrificing service: this health-care model might be just what the NP ordered for elderly care.(Health-Care Models)
June 25, 2007... A rapidly increasing elderly population means that our health-care system has to be able to accommodate a larger need for elder care. But with a dismal outlook on getting new geriatric physicians, nurse practitioners may be better suited for...

Predicting Alzheimer's: cognitive trouble and anxiety may offer clues: also: promising new AD drug moves quickly toward Phase III trial.(Alzheimer's Disease)
June 25, 2007... Knowing about a new list of possible Alzheimer's indicators may help with early detection. A study published in the journal Neurology reported that "simple cognitive tests can help predict the likelihood that a person with mild cognitive...

Grassroots AD organizations in 14 States will reap rewards: Alzheimer's foundation 2005 grants to fund impressive list of programs.(Funding)
June 25, 2007... A Florida organization called Alzheimer's Community Care will be defraying the costs of prescription drugs for its clients thanks to a recent grant. And a laundry list of other organizations nationwide will also receive funding for...

Part D confusion most likely led to big losses: GAO: Part D payments withheld from dual eligibles.(Medicare Part D)
June 25, 2007... Confusion at the onset of Medicare Part D may have led to losses for the program--and unreimbursed drug costs for low-income patients, a new report suggests. A new report from the Government Accountability Office notes that Medicare paid...

Good news for pharmacists: state moves could soften blow of low payments: more pay for dispensing is one solution. (Prescription Drugs).
June 25, 2007... State Medicaid directors may be stymied by the federal plan to alter the base rate for generic drug reimbursement, but some state legislators are beginning to act to mitigate the expected impact on pharmacies. Although the Centers for...

Why benes aren't reaping the benefits of account-based health plans: and Aetna is innovating its benefit designs once again.(Health Plans)
June 25, 2007... Not only are your benes less satisfied with their account-based health plans, they "lack the competency and confidence" to use the plans to their full potential, according to a new study by Towers Perrin. Participants in the study felt...

Feds downplay pricing fluctuations for generics: second report: proposed generic pricing could stick.(Medicaid)
June 25, 2007... With no final rule on Medicaid pricing for generic prescription drugs, pharmacists are wondering how hard the rule will hit their business. A new report may lend at least a few clues to what the future holds. The June 6 draft report from...

Doctors can't dispense DME to anyone else's patients: physicians prepare for hassles with winning DME bidders.(Durable Medical Equipment)
June 25, 2007... Now's the time for physicians to make sure their durable medical equipment dispensing practices meet the requirements to avoid the tough competitive-bidding process. The Centers for Medicare & Medicaid Services just launched the bidding...

Slow down on pay for reporting/performance, Senator demands.(Industry Notes)
June 25, 2007... Doctors could gain some breathing room on changes to the Physician Quality Reporting Initiative next year and avoid any pay-for-performance plans, if a new bill becomes law. Senators Benjamin Cardin (D-MD) and Arlen Specter (R-PA)...

Elderly who direct their own home care reap benefits.(Industry Notes)
June 25, 2007... Barring mental disabilities, seniors are frequently capable of determining their own health care needs and deciding when the time has come for transfer to a nursing facility. With this in mind, Alabama has become the first state in the...

The dizzying growth in Medicare spending on physician services came as a result of physicians providing more services, not Medicare spending more per service, according to a new report from the Congressional Budget Office.(In Other News ...)
June 25, 2007... The dizzying growth in Medicare spending on physician services came as a result of physicians providing more services, not Medicare spending more per service, according to a new report from the Congressional Budget Office. After inflation,...

If providers are experiencing denials or payment delays because of the new national provider identifier requirement, they need to make sure all of their information in the NPI data file is accurate, say experts.(In Other News ...)
June 25, 2007... If providers are experiencing denials or payment delays because of the new national provider identifier requirement, they need to make sure all of their information in the NPI data file is accurate, say experts. If the address or other contact...

Physicians will soon have 10 new quality measures to help them improve their performance.(In Other News ...)
June 25, 2007... Physicians will soon have 10 new quality measures to help them improve their performance. The Physician Consortium for Performance Improvement, convened by the American Medical Association, approved the measures, which are online at...