Jane Anderson

Half of Health Spending Wasted

Wasteful spending in the U.S. health system could amount to as much as $1.2 trillion of the $2.2 trillion spent annually, according to a report released by the PricewaterhouseCoopers' Health Research Institute. Defensive medicine was identified as the biggest area of excess, followed by inefficient administration and the cost of care necessitated by preventable conditions, such as obesity, according to the report. The impact of issues such as nonadherence to medical advice and prescriptions, alcohol abuse, smoking, and obesity “are exponential,” the report said.

N.Y. Needs More Doctors

The job market for new physicians in New York is characterized by strong demand, according to a recent study from the Center for Health Workforce Studies at the University of Albany School of Public Health. Unlike previous years, the need for primary care physicians was comparable with the demand for specialists, with new primary care doctors reporting an increasing number of job offers and increasing median starting income. Demand for new physicians was strongest in specialties that included dermatology, pulmonology, gastroenterology, and cardiology, whereas demand was weakest for physicians in ophthalmology, general pediatrics, pathology, and physical medicine and rehabilitation. In addition, the median starting income for new physicians grew by 13% from 2005 to 2007. Median starting income was $142,100 for primary care physicians.

Self-Referrals Drive Imaging Hike

Physicians who refer patients to their own facilities or machines for scans account for much of the increase in diagnostic imaging that is ordered for privately insured patients, according to a commentary in the journal Medical Care. The increases in imaging were seen mainly in privately insured patients with fee-for-service plans, according to Dr. Vivian Ho, professor of medicine at Baylor College of Medicine, Houston. “Physicians seem to choose the self-referral option, meaning they do the imaging in their own office, because they are reimbursed by private insurance companies,” Dr. Ho wrote. If they don't have the equipment in their office, she said, then they lease an imaging center's facilities and employees for a fixed period each week. This creates revenue for both parties involved, but it also raises questions about the necessity of the testing that is conducted, Dr. Ho wrote, adding that “the current reimbursement system lacks incentives to provide high quality imaging in a cost-effective manner.”

Disciplinary Actions Decline

The number and rate of serious disciplinary actions brought against physicians has decreased for the third consecutive year, according to Public Citizen's annual ranking of state medical boards. The advocacy group said that the analysis indicates that many states are not living up to their obligations to protect patients from bad doctors. Since 2004, the number of serious disciplinary actions against doctors has decreased by 17%, which has resulted in 553 fewer serious actions in 2007 than in 2004. Taking into account the increasing number of U.S. physicians since 2004, the rate of serious actions has fallen 22% since then, when calculated per 1,000 physicians, according to Public Citizen. The annual rankings of the states are based on data from the Federation of State Medical Boards.

Direct-to-Consumer Genetic Testing

Patients should be fully informed about how to interpret direct-to-consumer genetic tests, which provide only the probability of developing a disease, according to a new policy statement from the American College of Medical Genetics. The organization outlined minimum requirements for the use of any genetic testing protocol, including that patients be informed about the scientific evidence on which the test is based, that a knowledgeable professional should be involved in ordering and interpreting the test, that the clinical testing laboratory is properly accredited, and that privacy concerns are addressed. “Consumers need to be cautious and always involve their healthcare provider, and in some cases a medical geneticist or genetic counselor, in their decisions about genetic testing,” Michael S. Watson, Ph.D., executive director of the American College of Medical Genetics, said in a statement. The full policy statement is available online at

www.acmg.net

'Tectonic Shifts' Seen in Data

As large corporations, such as Google and Microsoft, move into the business of creating platforms for personal electronic health records, the shift in the health information landscape will profoundly affect biomedical research and raise new privacy issues, two physicians wrote in the New England Journal of Medicine. The electronic health record raises a series of questions, the authors wrote. For example, will those who provide and host electronic health records—which may be huge, non- health-related corporations—take on a research mission? And, if so, who will have access to the data, for what purposes, and under what sort of regulation? In addition, will academic researchers have full access to the data? The authors also pointed out that the companies providing personally controlled health records are not covered entities under the Health Insurance Portability and Accountability Act. Legislation has been introduced in Congress to dictate the structure, governance, and financing of personal electronic health records, but no law has been approved.

Half of Health Spending Wasted

Wasteful spending in the U.S. health system could amount to as much as $1.2 trillion of the $2.2 trillion spent annually, according to a report released by the PricewaterhouseCoopers' Health Research Institute. Defensive medicine was identified as the biggest area of excess, followed by inefficient administration and the cost of care necessitated by preventable conditions, such as obesity, according to the report. The impact of issues such as nonadherence to medical advice and prescriptions, alcohol abuse, smoking, and obesity “are exponential,” the report said.

N.Y. Needs More Doctors

The job market for new physicians in New York is characterized by strong demand, according to a recent study from the Center for Health Workforce Studies at the University of Albany School of Public Health. Unlike previous years, the need for primary care physicians was comparable with the demand for specialists, with new primary care doctors reporting an increasing number of job offers and increasing median starting income. Demand for new physicians was strongest in specialties that included dermatology, pulmonology, gastroenterology, and cardiology, whereas demand was weakest for physicians in ophthalmology, general pediatrics, pathology, and physical medicine and rehabilitation. In addition, the median starting income for new physicians grew by 13% from 2005 to 2007. Median starting income was $142,100 for primary care physicians.

Self-Referrals Drive Imaging Hike

Physicians who refer patients to their own facilities or machines for scans account for much of the increase in diagnostic imaging that is ordered for privately insured patients, according to a commentary in the journal Medical Care. The increases in imaging were seen mainly in privately insured patients with fee-for-service plans, according to Dr. Vivian Ho, professor of medicine at Baylor College of Medicine, Houston. “Physicians seem to choose the self-referral option, meaning they do the imaging in their own office, because they are reimbursed by private insurance companies,” Dr. Ho wrote. If they don't have the equipment in their office, she said, then they lease an imaging center's facilities and employees for a fixed period each week. This creates revenue for both parties involved, but it also raises questions about the necessity of the testing that is conducted, Dr. Ho wrote, adding that “the current reimbursement system lacks incentives to provide high quality imaging in a cost-effective manner.”

Disciplinary Actions Decline

The number and rate of serious disciplinary actions brought against physicians has decreased for the third consecutive year, according to Public Citizen's annual ranking of state medical boards. The advocacy group said that the analysis indicates that many states are not living up to their obligations to protect patients from bad doctors. Since 2004, the number of serious disciplinary actions against doctors has decreased by 17%, which has resulted in 553 fewer serious actions in 2007 than in 2004. Taking into account the increasing number of U.S. physicians since 2004, the rate of serious actions has fallen 22% since then, when calculated per 1,000 physicians, according to Public Citizen. The annual rankings of the states are based on data from the Federation of State Medical Boards.

Direct-to-Consumer Genetic Testing

Patients should be fully informed about how to interpret direct-to-consumer genetic tests, which provide only the probability of developing a disease, according to a new policy statement from the American College of Medical Genetics. The organization outlined minimum requirements for the use of any genetic testing protocol, including that patients be informed about the scientific evidence on which the test is based, that a knowledgeable professional should be involved in ordering and interpreting the test, that the clinical testing laboratory is properly accredited, and that privacy concerns are addressed. “Consumers need to be cautious and always involve their healthcare provider, and in some cases a medical geneticist or genetic counselor, in their decisions about genetic testing,” Michael S. Watson, Ph.D., executive director of the American College of Medical Genetics, said in a statement. The full policy statement is available online at

www.acmg.net

'Tectonic Shifts' Seen in Data

As large corporations, such as Google and Microsoft, move into the business of creating platforms for personal electronic health records, the shift in the health information landscape will profoundly affect biomedical research and raise new privacy issues, two physicians wrote in the New England Journal of Medicine. The electronic health record raises a series of questions, the authors wrote. For example, will those who provide and host electronic health records—which may be huge, non- health-related corporations—take on a research mission? And, if so, who will have access to the data, for what purposes, and under what sort of regulation? In addition, will academic researchers have full access to the data? The authors also pointed out that the companies providing personally controlled health records are not covered entities under the Health Insurance Portability and Accountability Act. Legislation has been introduced in Congress to dictate the structure, governance, and financing of personal electronic health records, but no law has been approved.

Half of Health Spending Wasted

Wasteful spending in the U.S. health system could amount to as much as $1.2 trillion of the $2.2 trillion spent annually, according to a report released by the PricewaterhouseCoopers' Health Research Institute. Defensive medicine was identified as the biggest area of excess, followed by inefficient administration and the cost of care necessitated by preventable conditions, such as obesity, according to the report. The impact of issues such as nonadherence to medical advice and prescriptions, alcohol abuse, smoking, and obesity “are exponential,” the report said.

N.Y. Needs More Doctors

The job market for new physicians in New York is characterized by strong demand, according to a recent study from the Center for Health Workforce Studies at the University of Albany School of Public Health. Unlike previous years, the need for primary care physicians was comparable with the demand for specialists, with new primary care doctors reporting an increasing number of job offers and increasing median starting income. Demand for new physicians was strongest in specialties that included dermatology, pulmonology, gastroenterology, and cardiology, whereas demand was weakest for physicians in ophthalmology, general pediatrics, pathology, and physical medicine and rehabilitation. In addition, the median starting income for new physicians grew by 13% from 2005 to 2007. Median starting income was $142,100 for primary care physicians.

Self-Referrals Drive Imaging Hike

Physicians who refer patients to their own facilities or machines for scans account for much of the increase in diagnostic imaging that is ordered for privately insured patients, according to a commentary in the journal Medical Care. The increases in imaging were seen mainly in privately insured patients with fee-for-service plans, according to Dr. Vivian Ho, professor of medicine at Baylor College of Medicine, Houston. “Physicians seem to choose the self-referral option, meaning they do the imaging in their own office, because they are reimbursed by private insurance companies,” Dr. Ho wrote. If they don't have the equipment in their office, she said, then they lease an imaging center's facilities and employees for a fixed period each week. This creates revenue for both parties involved, but it also raises questions about the necessity of the testing that is conducted, Dr. Ho wrote, adding that “the current reimbursement system lacks incentives to provide high quality imaging in a cost-effective manner.”

Disciplinary Actions Decline

The number and rate of serious disciplinary actions brought against physicians has decreased for the third consecutive year, according to Public Citizen's annual ranking of state medical boards. The advocacy group said that the analysis indicates that many states are not living up to their obligations to protect patients from bad doctors. Since 2004, the number of serious disciplinary actions against doctors has decreased by 17%, which has resulted in 553 fewer serious actions in 2007 than in 2004. Taking into account the increasing number of U.S. physicians since 2004, the rate of serious actions has fallen 22% since then, when calculated per 1,000 physicians, according to Public Citizen. The annual rankings of the states are based on data from the Federation of State Medical Boards.

Direct-to-Consumer Genetic Testing

Patients should be fully informed about how to interpret direct-to-consumer genetic tests, which provide only the probability of developing a disease, according to a new policy statement from the American College of Medical Genetics. The organization outlined minimum requirements for the use of any genetic testing protocol, including that patients be informed about the scientific evidence on which the test is based, that a knowledgeable professional should be involved in ordering and interpreting the test, that the clinical testing laboratory is properly accredited, and that privacy concerns are addressed. “Consumers need to be cautious and always involve their healthcare provider, and in some cases a medical geneticist or genetic counselor, in their decisions about genetic testing,” Michael S. Watson, Ph.D., executive director of the American College of Medical Genetics, said in a statement. The full policy statement is available online at

www.acmg.net

'Tectonic Shifts' Seen in Data

As large corporations, such as Google and Microsoft, move into the business of creating platforms for personal electronic health records, the shift in the health information landscape will profoundly affect biomedical research and raise new privacy issues, two physicians wrote in the New England Journal of Medicine. The electronic health record raises a series of questions, the authors wrote. For example, will those who provide and host electronic health records—which may be huge, non- health-related corporations—take on a research mission? And, if so, who will have access to the data, for what purposes, and under what sort of regulation? In addition, will academic researchers have full access to the data? The authors also pointed out that the companies providing personally controlled health records are not covered entities under the Health Insurance Portability and Accountability Act. Legislation has been introduced in Congress to dictate the structure, governance, and financing of personal electronic health records, but no law has been approved.

Half of Health Spending Wasted

Wasteful spending in the U.S. health system could amount to as much as $1.2 trillion of the $2.2 trillion spent annually, according to a report from the PricewaterhouseCoopers' Health Research Institute. Defensive medicine was identified as the biggest area of excess, followed by inefficient administration and the cost of care necessitated by preventable conditions, such as obesity, according to the report. The impact of issues such as nonadherence to medical advice and prescriptions, alcohol abuse, smoking, and obesity “are exponential,” the report said.

N.Y. Needs More Doctors

The job market for new physicians in New York is characterized by strong demand, according to a recent study from the Center for Health Workforce Studies at the University of Albany School of Public Health. Unlike previous years, the need for primary care physicians was comparable with the demand for specialists, with new primary care doctors reporting an increasing number of job offers and increasing median starting income. Demand for new physicians was strongest in specialties, including dermatology, pulmonology, gastroenterology, and cardiology, whereas demand was weakest for physicians in ophthalmology, general pediatrics, pathology, and physical medicine and rehabilitation. In addition, the median starting income for new physicians grew by 13% from 2005 to 2007. Median starting income was $142,100 for primary care physicians.

Self-Referrals Drive Imaging Hike

Physicians who refer patients to their own facilities or machines for scans account for much of the increase in diagnostic imaging ordered for privately insured patients, according to a commentary in the journal Medical Care. The increases in imaging were seen mainly in privately insured patients with fee-for-service plans, according to Dr. Vivian Ho, professor of medicine at Baylor College of Medicine, Houston. “Physicians seem to choose the self-referral option, meaning they do the imaging in their own office, because they are reimbursed by private insurance companies,” Dr. Ho wrote. If they don't have the equipment in their office, she said, they lease an imaging center's facilities and employees for a fixed period each week. This creates revenue for both parties involved, but raises questions about the necessity of the testing conducted, Dr. Ho wrote, adding, “The current reimbursement system lacks incentives to provide high-quality imaging in a cost-effective manner.”

Disciplinary Actions Decline

The number and rate of serious disciplinary actions against physicians have decreased for the third consecutive year, according to Public Citizen's annual ranking of state medical boards. The advocacy group said the analysis indicates that many states are not living up to their obligations to protect patients from bad doctors. Since 2004, the number of serious disciplinary actions against doctors has decreased 17%, resulting in 553 fewer serious actions in 2007 than in 2004. Taking into account the increasing number of U.S. physicians since 2004, the rate of serious actions has fallen 22% since then, when calculated per 1,000 physicians, according to Public Citizen. The annual rankings are based on data from the Federation of State Medical Boards.

Direct-to-Consumer Genetic Testing

Patients should be fully informed about how to interpret direct-to-consumer genetic tests, which provide only the probability of developing a disease, according to a new policy statement from the American College of Medical Genetics. The organization outlined minimum requirements for the use of any genetic testing protocol, including that patients be informed about the scientific evidence on which the test is based, that a knowledgeable professional should be involved in ordering and interpreting the test, that the clinical testing laboratory is properly accredited, and that privacy concerns are addressed. “Consumers need to be cautious and always involve their health care provider, and in some cases a medical geneticist or genetic counselor, in their decisions about genetic testing,” Michael S. Watson, Ph.D., executive director of the American College of Medical Genetics, said in a statement. The full policy statement is available online at

www.acmg.net

'Tectonic Shifts' Seen in Data

As large corporations, such as Google and Microsoft, move into the business of creating platforms for personal electronic health records, the shift in the health information landscape will profoundly affect biomedical research and raise new privacy issues, two physicians wrote in the New England Journal of Medicine. The electronic health record raises a series of questions, the authors wrote. For example, will those who provide and host electronic health records—which may be huge, non-health-related corporations—take on a research mission? And, if so, who will have access to the data, for what purposes, and under what sort of regulation? In addition, will academic researchers have full access to the data? The authors also pointed out that the companies providing personally controlled health records are not covered entities under the Health Insurance Portability and Accountability Act. Legislation has been introduced in Congress to dictate the structure, governance, and financing of personal electronic health records, but no law has been approved.

Half of Health Spending Wasted

Wasteful spending in the U.S. health system could amount to as much as $1.2 trillion of the $2.2 trillion spent annually, according to a report from the PricewaterhouseCoopers' Health Research Institute. Defensive medicine was identified as the biggest area of excess, followed by inefficient administration and the cost of care necessitated by preventable conditions, such as obesity, according to the report. The impact of issues such as nonadherence to medical advice and prescriptions, alcohol abuse, smoking, and obesity “are exponential,” the report said.

N.Y. Needs More Doctors

The job market for new physicians in New York is characterized by strong demand, according to a recent study from the Center for Health Workforce Studies at the University of Albany School of Public Health. Unlike previous years, the need for primary care physicians was comparable with the demand for specialists, with new primary care doctors reporting an increasing number of job offers and increasing median starting income. Demand for new physicians was strongest in specialties, including dermatology, pulmonology, gastroenterology, and cardiology, whereas demand was weakest for physicians in ophthalmology, general pediatrics, pathology, and physical medicine and rehabilitation. In addition, the median starting income for new physicians grew by 13% from 2005 to 2007. Median starting income was $142,100 for primary care physicians.

Self-Referrals Drive Imaging Hike

Physicians who refer patients to their own facilities or machines for scans account for much of the increase in diagnostic imaging ordered for privately insured patients, according to a commentary in the journal Medical Care. The increases in imaging were seen mainly in privately insured patients with fee-for-service plans, according to Dr. Vivian Ho, professor of medicine at Baylor College of Medicine, Houston. “Physicians seem to choose the self-referral option, meaning they do the imaging in their own office, because they are reimbursed by private insurance companies,” Dr. Ho wrote. If they don't have the equipment in their office, she said, they lease an imaging center's facilities and employees for a fixed period each week. This creates revenue for both parties involved, but raises questions about the necessity of the testing conducted, Dr. Ho wrote, adding, “The current reimbursement system lacks incentives to provide high-quality imaging in a cost-effective manner.”

Disciplinary Actions Decline

The number and rate of serious disciplinary actions against physicians have decreased for the third consecutive year, according to Public Citizen's annual ranking of state medical boards. The advocacy group said the analysis indicates that many states are not living up to their obligations to protect patients from bad doctors. Since 2004, the number of serious disciplinary actions against doctors has decreased 17%, resulting in 553 fewer serious actions in 2007 than in 2004. Taking into account the increasing number of U.S. physicians since 2004, the rate of serious actions has fallen 22% since then, when calculated per 1,000 physicians, according to Public Citizen. The annual rankings are based on data from the Federation of State Medical Boards.

Direct-to-Consumer Genetic Testing

Patients should be fully informed about how to interpret direct-to-consumer genetic tests, which provide only the probability of developing a disease, according to a new policy statement from the American College of Medical Genetics. The organization outlined minimum requirements for the use of any genetic testing protocol, including that patients be informed about the scientific evidence on which the test is based, that a knowledgeable professional should be involved in ordering and interpreting the test, that the clinical testing laboratory is properly accredited, and that privacy concerns are addressed. “Consumers need to be cautious and always involve their health care provider, and in some cases a medical geneticist or genetic counselor, in their decisions about genetic testing,” Michael S. Watson, Ph.D., executive director of the American College of Medical Genetics, said in a statement. The full policy statement is available online at

www.acmg.net

'Tectonic Shifts' Seen in Data

As large corporations, such as Google and Microsoft, move into the business of creating platforms for personal electronic health records, the shift in the health information landscape will profoundly affect biomedical research and raise new privacy issues, two physicians wrote in the New England Journal of Medicine. The electronic health record raises a series of questions, the authors wrote. For example, will those who provide and host electronic health records—which may be huge, non-health-related corporations—take on a research mission? And, if so, who will have access to the data, for what purposes, and under what sort of regulation? In addition, will academic researchers have full access to the data? The authors also pointed out that the companies providing personally controlled health records are not covered entities under the Health Insurance Portability and Accountability Act. Legislation has been introduced in Congress to dictate the structure, governance, and financing of personal electronic health records, but no law has been approved.

Half of Health Spending Wasted

Wasteful spending in the U.S. health system could amount to as much as $1.2 trillion of the $2.2 trillion spent annually, according to a report from the PricewaterhouseCoopers' Health Research Institute. Defensive medicine was identified as the biggest area of excess, followed by inefficient administration and the cost of care necessitated by preventable conditions, such as obesity, according to the report. The impact of issues such as nonadherence to medical advice and prescriptions, alcohol abuse, smoking, and obesity “are exponential,” the report said.

N.Y. Needs More Doctors

The job market for new physicians in New York is characterized by strong demand, according to a recent study from the Center for Health Workforce Studies at the University of Albany School of Public Health. Unlike previous years, the need for primary care physicians was comparable with the demand for specialists, with new primary care doctors reporting an increasing number of job offers and increasing median starting income. Demand for new physicians was strongest in specialties, including dermatology, pulmonology, gastroenterology, and cardiology, whereas demand was weakest for physicians in ophthalmology, general pediatrics, pathology, and physical medicine and rehabilitation. In addition, the median starting income for new physicians grew by 13% from 2005 to 2007. Median starting income was $142,100 for primary care physicians.

Self-Referrals Drive Imaging Hike

Physicians who refer patients to their own facilities or machines for scans account for much of the increase in diagnostic imaging ordered for privately insured patients, according to a commentary in the journal Medical Care. The increases in imaging were seen mainly in privately insured patients with fee-for-service plans, according to Dr. Vivian Ho, professor of medicine at Baylor College of Medicine, Houston. “Physicians seem to choose the self-referral option, meaning they do the imaging in their own office, because they are reimbursed by private insurance companies,” Dr. Ho wrote. If they don't have the equipment in their office, she said, they lease an imaging center's facilities and employees for a fixed period each week. This creates revenue for both parties involved, but raises questions about the necessity of the testing conducted, Dr. Ho wrote, adding, “The current reimbursement system lacks incentives to provide high-quality imaging in a cost-effective manner.”

Disciplinary Actions Decline

The number and rate of serious disciplinary actions against physicians have decreased for the third consecutive year, according to Public Citizen's annual ranking of state medical boards. The advocacy group said the analysis indicates that many states are not living up to their obligations to protect patients from bad doctors. Since 2004, the number of serious disciplinary actions against doctors has decreased 17%, resulting in 553 fewer serious actions in 2007 than in 2004. Taking into account the increasing number of U.S. physicians since 2004, the rate of serious actions has fallen 22% since then, when calculated per 1,000 physicians, according to Public Citizen. The annual rankings are based on data from the Federation of State Medical Boards.

Direct-to-Consumer Genetic Testing

Patients should be fully informed about how to interpret direct-to-consumer genetic tests, which provide only the probability of developing a disease, according to a new policy statement from the American College of Medical Genetics. The organization outlined minimum requirements for the use of any genetic testing protocol, including that patients be informed about the scientific evidence on which the test is based, that a knowledgeable professional should be involved in ordering and interpreting the test, that the clinical testing laboratory is properly accredited, and that privacy concerns are addressed. “Consumers need to be cautious and always involve their health care provider, and in some cases a medical geneticist or genetic counselor, in their decisions about genetic testing,” Michael S. Watson, Ph.D., executive director of the American College of Medical Genetics, said in a statement. The full policy statement is available online at

www.acmg.net

'Tectonic Shifts' Seen in Data

As large corporations, such as Google and Microsoft, move into the business of creating platforms for personal electronic health records, the shift in the health information landscape will profoundly affect biomedical research and raise new privacy issues, two physicians wrote in the New England Journal of Medicine. The electronic health record raises a series of questions, the authors wrote. For example, will those who provide and host electronic health records—which may be huge, non-health-related corporations—take on a research mission? And, if so, who will have access to the data, for what purposes, and under what sort of regulation? In addition, will academic researchers have full access to the data? The authors also pointed out that the companies providing personally controlled health records are not covered entities under the Health Insurance Portability and Accountability Act. Legislation has been introduced in Congress to dictate the structure, governance, and financing of personal electronic health records, but no law has been approved.

Poor and uninsured Americans are less likely than wealthy or insured Americans to receive free drug samples, according to a study by physicians from Cambridge Health Alliance and Harvard Medical School.

The study found in 2003 12% of Americans got at least one free drug sample.

More people who were continuously insured received a free sample than people who were uninsured for all or part of the year, and the poorest third were less likely to receive free samples than were those with incomes at 400% of the federal poverty level or more (Am. J. Public Health 2008;98:284–9).

“We know that many doctors try to get free samples to needy patients,” said study senior author Dr. David Himmelstein in a statement. “Our findings strongly suggest that free drug samples serve as a marketing tool, not as a safety net.”

But Ken Johnson, senior vice president at the Pharmaceutical Research and Manufacturers of America, said free samples help millions of Americans, regardless of income, and help patients who can't afford medicines.

Poor and uninsured Americans are less likely than wealthy or insured Americans to receive free drug samples, according to a study by physicians from Cambridge Health Alliance and Harvard Medical School.

The study found in 2003 12% of Americans got at least one free drug sample.

More people who were continuously insured received a free sample than people who were uninsured for all or part of the year, and the poorest third were less likely to receive free samples than were those with incomes at 400% of the federal poverty level or more (Am. J. Public Health 2008;98:284–9).

“We know that many doctors try to get free samples to needy patients,” said study senior author Dr. David Himmelstein in a statement. “Our findings strongly suggest that free drug samples serve as a marketing tool, not as a safety net.”

But Ken Johnson, senior vice president at the Pharmaceutical Research and Manufacturers of America, said free samples help millions of Americans, regardless of income, and help patients who can't afford medicines.

Poor and uninsured Americans are less likely than wealthy or insured Americans to receive free drug samples, according to a study by physicians from Cambridge Health Alliance and Harvard Medical School.

The study found in 2003 12% of Americans got at least one free drug sample.

More people who were continuously insured received a free sample than people who were uninsured for all or part of the year, and the poorest third were less likely to receive free samples than were those with incomes at 400% of the federal poverty level or more (Am. J. Public Health 2008;98:284–9).

“We know that many doctors try to get free samples to needy patients,” said study senior author Dr. David Himmelstein in a statement. “Our findings strongly suggest that free drug samples serve as a marketing tool, not as a safety net.”

But Ken Johnson, senior vice president at the Pharmaceutical Research and Manufacturers of America, said free samples help millions of Americans, regardless of income, and help patients who can't afford medicines.

Newborn Screening Law Signed

Last month, Congress approved and President Bush signed legislation to establish national guidelines on comprehensive newborn screening. The Newborn Screening Saves Lives Act also provides federal funding to educate parents and health professionals about the importance of newborn screening, and improves the systems for follow-up care for infants with an illness detected through the tests. The American College of Medical Genetics recommends that every baby born in the United States be tested for 29 metabolic and functional disorders, but only 19 states and the District of Columbia currently require such testing. The American Academy of Pediatrics supported the legislation. The new law “expands and improves the supports offered by the federal government to ensure that states have the resources necessary to ensure that all newborns receive the necessary tests and appropriate follow-up care,” said AAP President Renee Jenkins in a statement.

Panel Looking at Vaccine Safety

The National Vaccine Advisory Committee's Vaccine Safety Working Group last month began developing research priorities for the Centers for Disease Control and Prevention intended to guide the CDC's scientific direction over the next 5 years in vaccine safety research, selected surveillance, and selected clinical guidance activities. Based on testimony from both external and federal scientists, along with vaccine manufacturers' representatives and members of the general public, the panel is considering recommending enhancements in vaccine safety public health and clinical guidance in seven areas ranging from the Vaccine Adverse Event Reporting System and the Vaccine Safety Datalink Project to genomics and vaccine safety clinical practice guidelines. The committee also will address research needs in the areas of specific vaccine safety questions, vaccines and vaccination practices, special populations, and clinical outcomes.

Foodborne Illness Strategy Needed

A CDC report showed little change in the incidence of some foodborne infections after a period of decline, leading to a call for new foodborne-illness strategies. “The results show that prevention efforts have been partly successful, but there has been little further progress in the most recent years,” Dr. Robert Tauxe, deputy director of the agency's Division of Foodborne, Bacterial and Mycotic Diseases, said in a statement. The incidence of Campylobacter, Salmonella, Shigella, and Shiga toxin-producing Escherichia coli O157 infections remained highest among children under 5 years old, highlighting the need for targeted interventions, according to the CDC, which noted that identified risk factors for bacterial enteric illness in young children include riding in a shopping cart next to raw meat or poultry, attendance at day care, visiting or living on a farm, and living in a home with a reptile.

Poor Medicaid Dental Access Noted

Children in families with low incomes suffer disproportionately from dental caries, and even though state Medicaid programs are required to provide dental services to eligible children, enrollees' access to care is poor, according to a report. The study from the National Academy for State Health Policy said that in 2006, only one in three children enrolled in Medicaid received a dental service. According to the report, dentists cite three primary reasons for their low participation in state Medicaid programs: low reimbursement, burdensome administrative requirements, and problematic patient behaviors. Rate increases are necessary—but not sufficient on their own—to improve access to dental care, according to the report. Easing administrative processes and involving state dental societies and individual dentists as active partners in program improvement also are critical, the report concluded, and working with patients and their families about how to use dental services is a core element of reforms.

Maryland Approves Dental Law

Beginning Oct. 1, dental hygienists in Maryland will be allowed to provide preventive care such as cleanings, sealants, and fluoride treatments in public health settings without dentist supervision, thanks to a new law. The new law, approved after an uninsured 12-year-old Maryland boy died last year from an untreated dental infection, permits dental hygienists to provide preventive care at public dental clinics, public health departments, public schools, and facilities housing Head Start programs. The legislation does not apply to dental hygienists working in privately owned facilities.

GAO: SCHIP Income Rule Is Invalid

A letter from the Bush administration issued last August that limited enrollment in the State Children's Health Insurance Program (SCHIP) violated federal law because the administration failed to follow the proper rule-making procedure, according to a legal opinion from the Government Accountability Office. Therefore, the SCHIP rule, which places difficult-to-meet restrictions on states that want to enroll children in families with incomes more than 250% of the federal poverty level, is unenforceable, the GAO said in its opinion. Because the letter, issued by the Centers for Medicare and Medicaid Services, amounts to a new rule that changes longstanding policy, it must be submitted to Congress and to the comptroller general before it can take effect. However, a CMS spokesperson said in a statement that the GAO legal opinion has had no effect on the CMS position, and the restrictions contained in the Aug. 17 letter still are in effect.

Newborn Screening Law Signed

Last month, Congress approved and President Bush signed legislation to establish national guidelines on comprehensive newborn screening. The Newborn Screening Saves Lives Act also provides federal funding to educate parents and health professionals about the importance of newborn screening, and improves the systems for follow-up care for infants with an illness detected through the tests. The American College of Medical Genetics recommends that every baby born in the United States be tested for 29 metabolic and functional disorders, but only 19 states and the District of Columbia currently require such testing. The American Academy of Pediatrics supported the legislation. The new law “expands and improves the supports offered by the federal government to ensure that states have the resources necessary to ensure that all newborns receive the necessary tests and appropriate follow-up care,” said AAP President Renee Jenkins in a statement.

Panel Looking at Vaccine Safety

The National Vaccine Advisory Committee's Vaccine Safety Working Group last month began developing research priorities for the Centers for Disease Control and Prevention intended to guide the CDC's scientific direction over the next 5 years in vaccine safety research, selected surveillance, and selected clinical guidance activities. Based on testimony from both external and federal scientists, along with vaccine manufacturers' representatives and members of the general public, the panel is considering recommending enhancements in vaccine safety public health and clinical guidance in seven areas ranging from the Vaccine Adverse Event Reporting System and the Vaccine Safety Datalink Project to genomics and vaccine safety clinical practice guidelines. The committee also will address research needs in the areas of specific vaccine safety questions, vaccines and vaccination practices, special populations, and clinical outcomes.

Foodborne Illness Strategy Needed

A CDC report showed little change in the incidence of some foodborne infections after a period of decline, leading to a call for new foodborne-illness strategies. “The results show that prevention efforts have been partly successful, but there has been little further progress in the most recent years,” Dr. Robert Tauxe, deputy director of the agency's Division of Foodborne, Bacterial and Mycotic Diseases, said in a statement. The incidence of Campylobacter, Salmonella, Shigella, and Shiga toxin-producing Escherichia coli O157 infections remained highest among children under 5 years old, highlighting the need for targeted interventions, according to the CDC, which noted that identified risk factors for bacterial enteric illness in young children include riding in a shopping cart next to raw meat or poultry, attendance at day care, visiting or living on a farm, and living in a home with a reptile.

Poor Medicaid Dental Access Noted

Children in families with low incomes suffer disproportionately from dental caries, and even though state Medicaid programs are required to provide dental services to eligible children, enrollees' access to care is poor, according to a report. The study from the National Academy for State Health Policy said that in 2006, only one in three children enrolled in Medicaid received a dental service. According to the report, dentists cite three primary reasons for their low participation in state Medicaid programs: low reimbursement, burdensome administrative requirements, and problematic patient behaviors. Rate increases are necessary—but not sufficient on their own—to improve access to dental care, according to the report. Easing administrative processes and involving state dental societies and individual dentists as active partners in program improvement also are critical, the report concluded, and working with patients and their families about how to use dental services is a core element of reforms.

Maryland Approves Dental Law

Beginning Oct. 1, dental hygienists in Maryland will be allowed to provide preventive care such as cleanings, sealants, and fluoride treatments in public health settings without dentist supervision, thanks to a new law. The new law, approved after an uninsured 12-year-old Maryland boy died last year from an untreated dental infection, permits dental hygienists to provide preventive care at public dental clinics, public health departments, public schools, and facilities housing Head Start programs. The legislation does not apply to dental hygienists working in privately owned facilities.

GAO: SCHIP Income Rule Is Invalid

A letter from the Bush administration issued last August that limited enrollment in the State Children's Health Insurance Program (SCHIP) violated federal law because the administration failed to follow the proper rule-making procedure, according to a legal opinion from the Government Accountability Office. Therefore, the SCHIP rule, which places difficult-to-meet restrictions on states that want to enroll children in families with incomes more than 250% of the federal poverty level, is unenforceable, the GAO said in its opinion. Because the letter, issued by the Centers for Medicare and Medicaid Services, amounts to a new rule that changes longstanding policy, it must be submitted to Congress and to the comptroller general before it can take effect. However, a CMS spokesperson said in a statement that the GAO legal opinion has had no effect on the CMS position, and the restrictions contained in the Aug. 17 letter still are in effect.

Newborn Screening Law Signed

Last month, Congress approved and President Bush signed legislation to establish national guidelines on comprehensive newborn screening. The Newborn Screening Saves Lives Act also provides federal funding to educate parents and health professionals about the importance of newborn screening, and improves the systems for follow-up care for infants with an illness detected through the tests. The American College of Medical Genetics recommends that every baby born in the United States be tested for 29 metabolic and functional disorders, but only 19 states and the District of Columbia currently require such testing. The American Academy of Pediatrics supported the legislation. The new law “expands and improves the supports offered by the federal government to ensure that states have the resources necessary to ensure that all newborns receive the necessary tests and appropriate follow-up care,” said AAP President Renee Jenkins in a statement.

Panel Looking at Vaccine Safety

The National Vaccine Advisory Committee's Vaccine Safety Working Group last month began developing research priorities for the Centers for Disease Control and Prevention intended to guide the CDC's scientific direction over the next 5 years in vaccine safety research, selected surveillance, and selected clinical guidance activities. Based on testimony from both external and federal scientists, along with vaccine manufacturers' representatives and members of the general public, the panel is considering recommending enhancements in vaccine safety public health and clinical guidance in seven areas ranging from the Vaccine Adverse Event Reporting System and the Vaccine Safety Datalink Project to genomics and vaccine safety clinical practice guidelines. The committee also will address research needs in the areas of specific vaccine safety questions, vaccines and vaccination practices, special populations, and clinical outcomes.

Foodborne Illness Strategy Needed

A CDC report showed little change in the incidence of some foodborne infections after a period of decline, leading to a call for new foodborne-illness strategies. “The results show that prevention efforts have been partly successful, but there has been little further progress in the most recent years,” Dr. Robert Tauxe, deputy director of the agency's Division of Foodborne, Bacterial and Mycotic Diseases, said in a statement. The incidence of Campylobacter, Salmonella, Shigella, and Shiga toxin-producing Escherichia coli O157 infections remained highest among children under 5 years old, highlighting the need for targeted interventions, according to the CDC, which noted that identified risk factors for bacterial enteric illness in young children include riding in a shopping cart next to raw meat or poultry, attendance at day care, visiting or living on a farm, and living in a home with a reptile.

Poor Medicaid Dental Access Noted

Children in families with low incomes suffer disproportionately from dental caries, and even though state Medicaid programs are required to provide dental services to eligible children, enrollees' access to care is poor, according to a report. The study from the National Academy for State Health Policy said that in 2006, only one in three children enrolled in Medicaid received a dental service. According to the report, dentists cite three primary reasons for their low participation in state Medicaid programs: low reimbursement, burdensome administrative requirements, and problematic patient behaviors. Rate increases are necessary—but not sufficient on their own—to improve access to dental care, according to the report. Easing administrative processes and involving state dental societies and individual dentists as active partners in program improvement also are critical, the report concluded, and working with patients and their families about how to use dental services is a core element of reforms.

Maryland Approves Dental Law

Beginning Oct. 1, dental hygienists in Maryland will be allowed to provide preventive care such as cleanings, sealants, and fluoride treatments in public health settings without dentist supervision, thanks to a new law. The new law, approved after an uninsured 12-year-old Maryland boy died last year from an untreated dental infection, permits dental hygienists to provide preventive care at public dental clinics, public health departments, public schools, and facilities housing Head Start programs. The legislation does not apply to dental hygienists working in privately owned facilities.

GAO: SCHIP Income Rule Is Invalid

A letter from the Bush administration issued last August that limited enrollment in the State Children's Health Insurance Program (SCHIP) violated federal law because the administration failed to follow the proper rule-making procedure, according to a legal opinion from the Government Accountability Office. Therefore, the SCHIP rule, which places difficult-to-meet restrictions on states that want to enroll children in families with incomes more than 250% of the federal poverty level, is unenforceable, the GAO said in its opinion. Because the letter, issued by the Centers for Medicare and Medicaid Services, amounts to a new rule that changes longstanding policy, it must be submitted to Congress and to the comptroller general before it can take effect. However, a CMS spokesperson said in a statement that the GAO legal opinion has had no effect on the CMS position, and the restrictions contained in the Aug. 17 letter still are in effect.

Ga. Docs Collaborate on EHRs

Georgia physicians are collaborating with the state's Department of Community Health on adoption of Medicare electronic health records, the department said. The department intends to apply to the Centers for Medicare and Medicaid Services to participate in an EHR demonstration project, and department officials said they met with Georgia physicians in March to develop the program. Over a 5-year period, the demonstration project will provide financial incentives to small- and medium-size physician groups using certified EHRs to meet certain clinical measures. Bonuses will be provided each year, based on a physician group's score on a standardized survey that assesses the specific EHR functions a group employs to support the delivery of care.

Consumer-Directed Enrollment Low

More employers are offering consumer-directed health plans in efforts to shift greater responsibility to workers for health care costs, lifestyle choices, and treatment decisions, according to a new survey on the plans. However, enrollment still constitutes only a small percentage of those enrolled in all employer-sponsored health plans, because large employers have not yet structured their premium contributions to favor the consumer-directed options, said the survey from the Center for Studying Health System Change. While survey respondents were optimistic that consumer-directed health plans would become more prominent in health benefit offerings, the report said plans and employers seeking to foster greater enrollment may need to make health savings accounts and health reimbursement arrangements more appealing to enrollees.

MA, Part D Changes Announced

The out-of-pocket threshold for a beneficiary enrolled in a standard Medicare Part D drug plan will rise from $4,050 to $4,350 next year, while the initial deductible rises from $275 to $295, CMS announced. The out-of-pocket threshold is the point at which the Part D “doughnut hole” is satisfied and Medicare begins paying for most drug expenses, minus 5% copayments. At the same time, health insurers running Medicare Advantage plans will see average increases of about 3.6% in capitation rates in 2009, CMS said. This increase in capitation rates is slightly lower than the estimated 3.7% Medicare growth trend for 2009, CMS said. In addition, CMS said it will audit records from a sample of Medicare Advantage plans in an effort to determine if the plans are reporting diagnosis code information correctly. Diagnosis code information is used in setting capitation and payment rates for the plans.

Side Effects Underreported

One in six Americans who have taken a prescription drug experienced a side effect serious enough to send them to the doctor or hospital, but only 35% of consumers said they know they can report these side effects to the FDA, according to a Consumer Reports poll. Additionally, 81% of respondents said they had seen or heard an ad for prescription drugs within the last 30 days, almost all on television. Consumers Union, the nonprofit publisher of the magazine, gave the FDA a petition signed by nearly 56,000 consumers asking that a toll-free number and Web site be included in all television drug ads so people can easily report their serious side effects. “What better way for the FDA to let consumers know how to report serious problems with their medications than putting a toll-free number and Web site in all those drug ads we're bombarded by each day?” asked Liz Foley, campaign coordinator with Consumers Union, in a statement.

AAMC Adopts Medical Home

The Association of American Medical Colleges has adopted a formal position stating that every person should have access to a medical home. “We believe the medical home model holds great promise for improving Americans' health by ensuring that they have an ongoing relationship with a trusted medical professional,” said Dr. Darrell Kirch, AAMD president and CEO, in a statement. The AAMC position also said that further research and evaluation of the medical home model is needed and more evidence must be gathered on how the model is best implemented. In addition, payment for the model should “appropriately recognize and reward providers for prevention, care delivery, and coordination,” and “health care providers should be trained to understand and implement the medical home model within a team environment,” the AAMC said.

Gaps in Child Well-Being

Where a child is born and raised in the United States can make a huge difference to his or her chances of health and survival to adulthood, according to a report by the nonprofit, nonpartisan Every Child Matters Education Fund. Those born in the lowest-ranked states are twice as likely to die in their first year of life as are those born in the highest-ranked states, three times more likely to die between the ages of 1 and 14 years, and five times more likely to have mothers who received late or no prenatal care. They also are three times more likely to live in poverty and five times more likely to be uninsured, the report said. “It should no longer be politically acceptable to permit—or simply ignore—the vast differences in life chances that exist for children today,” said report author Michael Petit. The bottom 10 states included Louisiana, Mississippi, New Mexico, Oklahoma, Texas, South Carolina, Arkansas, Nevada, South Dakota, and Arizona. Vermont, Massachusetts, Connecticut, Rhode Island, and New Hampshire were the top five states.

Ga. Docs Collaborate on EHRs

Georgia physicians are collaborating with the state's Department of Community Health on adoption of Medicare electronic health records, the department said. The department intends to apply to the Centers for Medicare and Medicaid Services to participate in an EHR demonstration project, and department officials said they met with Georgia physicians in March to develop the program. Over a 5-year period, the demonstration project will provide financial incentives to small- and medium-size physician groups using certified EHRs to meet certain clinical measures. Bonuses will be provided each year, based on a physician group's score on a standardized survey that assesses the specific EHR functions a group employs to support the delivery of care.

Consumer-Directed Enrollment Low

More employers are offering consumer-directed health plans in efforts to shift greater responsibility to workers for health care costs, lifestyle choices, and treatment decisions, according to a new survey on the plans. However, enrollment still constitutes only a small percentage of those enrolled in all employer-sponsored health plans, because large employers have not yet structured their premium contributions to favor the consumer-directed options, said the survey from the Center for Studying Health System Change. While survey respondents were optimistic that consumer-directed health plans would become more prominent in health benefit offerings, the report said plans and employers seeking to foster greater enrollment may need to make health savings accounts and health reimbursement arrangements more appealing to enrollees.

MA, Part D Changes Announced

The out-of-pocket threshold for a beneficiary enrolled in a standard Medicare Part D drug plan will rise from $4,050 to $4,350 next year, while the initial deductible rises from $275 to $295, CMS announced. The out-of-pocket threshold is the point at which the Part D “doughnut hole” is satisfied and Medicare begins paying for most drug expenses, minus 5% copayments. At the same time, health insurers running Medicare Advantage plans will see average increases of about 3.6% in capitation rates in 2009, CMS said. This increase in capitation rates is slightly lower than the estimated 3.7% Medicare growth trend for 2009, CMS said. In addition, CMS said it will audit records from a sample of Medicare Advantage plans in an effort to determine if the plans are reporting diagnosis code information correctly. Diagnosis code information is used in setting capitation and payment rates for the plans.

Side Effects Underreported

One in six Americans who have taken a prescription drug experienced a side effect serious enough to send them to the doctor or hospital, but only 35% of consumers said they know they can report these side effects to the FDA, according to a Consumer Reports poll. Additionally, 81% of respondents said they had seen or heard an ad for prescription drugs within the last 30 days, almost all on television. Consumers Union, the nonprofit publisher of the magazine, gave the FDA a petition signed by nearly 56,000 consumers asking that a toll-free number and Web site be included in all television drug ads so people can easily report their serious side effects. “What better way for the FDA to let consumers know how to report serious problems with their medications than putting a toll-free number and Web site in all those drug ads we're bombarded by each day?” asked Liz Foley, campaign coordinator with Consumers Union, in a statement.

AAMC Adopts Medical Home

The Association of American Medical Colleges has adopted a formal position stating that every person should have access to a medical home. “We believe the medical home model holds great promise for improving Americans' health by ensuring that they have an ongoing relationship with a trusted medical professional,” said Dr. Darrell Kirch, AAMD president and CEO, in a statement. The AAMC position also said that further research and evaluation of the medical home model is needed and more evidence must be gathered on how the model is best implemented. In addition, payment for the model should “appropriately recognize and reward providers for prevention, care delivery, and coordination,” and “health care providers should be trained to understand and implement the medical home model within a team environment,” the AAMC said.

Gaps in Child Well-Being

Where a child is born and raised in the United States can make a huge difference to his or her chances of health and survival to adulthood, according to a report by the nonprofit, nonpartisan Every Child Matters Education Fund. Those born in the lowest-ranked states are twice as likely to die in their first year of life as are those born in the highest-ranked states, three times more likely to die between the ages of 1 and 14 years, and five times more likely to have mothers who received late or no prenatal care. They also are three times more likely to live in poverty and five times more likely to be uninsured, the report said. “It should no longer be politically acceptable to permit—or simply ignore—the vast differences in life chances that exist for children today,” said report author Michael Petit. The bottom 10 states included Louisiana, Mississippi, New Mexico, Oklahoma, Texas, South Carolina, Arkansas, Nevada, South Dakota, and Arizona. Vermont, Massachusetts, Connecticut, Rhode Island, and New Hampshire were the top five states.

Ga. Docs Collaborate on EHRs

Georgia physicians are collaborating with the state's Department of Community Health on adoption of Medicare electronic health records, the department said. The department intends to apply to the Centers for Medicare and Medicaid Services to participate in an EHR demonstration project, and department officials said they met with Georgia physicians in March to develop the program. Over a 5-year period, the demonstration project will provide financial incentives to small- and medium-size physician groups using certified EHRs to meet certain clinical measures. Bonuses will be provided each year, based on a physician group's score on a standardized survey that assesses the specific EHR functions a group employs to support the delivery of care.

Consumer-Directed Enrollment Low

More employers are offering consumer-directed health plans in efforts to shift greater responsibility to workers for health care costs, lifestyle choices, and treatment decisions, according to a new survey on the plans. However, enrollment still constitutes only a small percentage of those enrolled in all employer-sponsored health plans, because large employers have not yet structured their premium contributions to favor the consumer-directed options, said the survey from the Center for Studying Health System Change. While survey respondents were optimistic that consumer-directed health plans would become more prominent in health benefit offerings, the report said plans and employers seeking to foster greater enrollment may need to make health savings accounts and health reimbursement arrangements more appealing to enrollees.

MA, Part D Changes Announced

The out-of-pocket threshold for a beneficiary enrolled in a standard Medicare Part D drug plan will rise from $4,050 to $4,350 next year, while the initial deductible rises from $275 to $295, CMS announced. The out-of-pocket threshold is the point at which the Part D “doughnut hole” is satisfied and Medicare begins paying for most drug expenses, minus 5% copayments. At the same time, health insurers running Medicare Advantage plans will see average increases of about 3.6% in capitation rates in 2009, CMS said. This increase in capitation rates is slightly lower than the estimated 3.7% Medicare growth trend for 2009, CMS said. In addition, CMS said it will audit records from a sample of Medicare Advantage plans in an effort to determine if the plans are reporting diagnosis code information correctly. Diagnosis code information is used in setting capitation and payment rates for the plans.

Side Effects Underreported

One in six Americans who have taken a prescription drug experienced a side effect serious enough to send them to the doctor or hospital, but only 35% of consumers said they know they can report these side effects to the FDA, according to a Consumer Reports poll. Additionally, 81% of respondents said they had seen or heard an ad for prescription drugs within the last 30 days, almost all on television. Consumers Union, the nonprofit publisher of the magazine, gave the FDA a petition signed by nearly 56,000 consumers asking that a toll-free number and Web site be included in all television drug ads so people can easily report their serious side effects. “What better way for the FDA to let consumers know how to report serious problems with their medications than putting a toll-free number and Web site in all those drug ads we're bombarded by each day?” asked Liz Foley, campaign coordinator with Consumers Union, in a statement.

AAMC Adopts Medical Home

The Association of American Medical Colleges has adopted a formal position stating that every person should have access to a medical home. “We believe the medical home model holds great promise for improving Americans' health by ensuring that they have an ongoing relationship with a trusted medical professional,” said Dr. Darrell Kirch, AAMD president and CEO, in a statement. The AAMC position also said that further research and evaluation of the medical home model is needed and more evidence must be gathered on how the model is best implemented. In addition, payment for the model should “appropriately recognize and reward providers for prevention, care delivery, and coordination,” and “health care providers should be trained to understand and implement the medical home model within a team environment,” the AAMC said.

Gaps in Child Well-Being

Where a child is born and raised in the United States can make a huge difference to his or her chances of health and survival to adulthood, according to a report by the nonprofit, nonpartisan Every Child Matters Education Fund. Those born in the lowest-ranked states are twice as likely to die in their first year of life as are those born in the highest-ranked states, three times more likely to die between the ages of 1 and 14 years, and five times more likely to have mothers who received late or no prenatal care. They also are three times more likely to live in poverty and five times more likely to be uninsured, the report said. “It should no longer be politically acceptable to permit—or simply ignore—the vast differences in life chances that exist for children today,” said report author Michael Petit. The bottom 10 states included Louisiana, Mississippi, New Mexico, Oklahoma, Texas, South Carolina, Arkansas, Nevada, South Dakota, and Arizona. Vermont, Massachusetts, Connecticut, Rhode Island, and New Hampshire were the top five states.

Sen. Barbara Boxer (D-Calif.) has introduced legislation aimed at addressing the potential crisis in providing care for elderly Americans.

The bill, introduced in March, seeks to offer a combination of educational-loan forgiveness and career-advancement opportunities for health care professionals choosing practice in nursing homes.

The Caring for an Aging America Act, S. 2708, would have the federal government provide $130 million over 5 years to benefit physicians, physician assistants, advance practice nurses, psychologists, and social workers choosing geriatrics and gerontology.

Aid would come primarily through educational loan repayments for these professionals. The bill already has been endorsed by the American Geriatrics Society, the National Council on Aging, the National Association of Geriatric Education, the Alzheimer's Association, and the National Association of Social Workers.

The American Medical Directors Association (AMDA), which represents nursing facility practitioners, has approved the bill's concepts in principle. “I think overall, this really is a big step forward,” said Dr. Paul Katz, AMDA vice president and chief of geriatrics at the University of Rochester, N.Y.

To benefit from the loan repayment provisions, health care professionals would not only need to complete specialty training in geriatrics or gerontology but also agree to provide full-time clinical practice and service to older adults for a minimum of 2 years.

In addition, the bill would expand eligibility for the Nursing Education Loan Repayment Program to include registered nurses who complete specialty training and provide nursing services to older adults in long-term care settings.

The proposed law also would expand midcareer specialty training in long-term care services through an existing training-grant program.

Sen. Boxer also proposes creation of a Health and Long-Term Care Workforce Advisory Panel for an Aging America, which would advise federal policy makers on workforce issues related to long-term care for the country's aging population.

“The medical and health community is already struggling to meet the demand for geriatric health care and support services, and the need for trained professionals is only growing,” Sen. Boxer said in a statement. “This legislation will provide incentives to help encourage qualified practitioners to join the geriatrics and gerontology fields.”

At press time, AMDA's Public Policy Committee was reviewing the actual legislation, which Kathleen M. Wilson, the group's director of government affairs, said is made up of initiatives closely similar to the concepts endorsed last year.

The loan guarantees in the legislation could be worth up to $150,000 for a professional who provides full-time health care to older adults for 4 years.

“That's fairly substantial, and it has to be substantial to get peoples' attention,” Dr. Katz said. “That's something I've been preaching for a while.”

However, Dr. Katz also warned that the bill needs to better define “geriatric providers” for the purposes of the legislation's financial aid, especially non-physician providers.

“Right now, for physicians there's a formal process of being trained in geriatrics, so it's not an issue. But for social workers and therapists, there aren't always specialty courses.”

Dr. Katz also noted that the bill is not specific to long-term care. “It's focusing on geriatricians,” he said.

“What about people who want to practice in long-term care?” Overall, though, Dr. Katz said he supports the legislation.

Sen. Barbara Boxer (D-Calif.) has introduced legislation aimed at addressing the potential crisis in providing care for elderly Americans.

The bill, introduced in March, seeks to offer a combination of educational-loan forgiveness and career-advancement opportunities for health care professionals choosing practice in nursing homes.

The Caring for an Aging America Act, S. 2708, would have the federal government provide $130 million over 5 years to benefit physicians, physician assistants, advance practice nurses, psychologists, and social workers choosing geriatrics and gerontology.

Aid would come primarily through educational loan repayments for these professionals. The bill already has been endorsed by the American Geriatrics Society, the National Council on Aging, the National Association of Geriatric Education, the Alzheimer's Association, and the National Association of Social Workers.

The American Medical Directors Association (AMDA), which represents nursing facility practitioners, has approved the bill's concepts in principle. “I think overall, this really is a big step forward,” said Dr. Paul Katz, AMDA vice president and chief of geriatrics at the University of Rochester, N.Y.

To benefit from the loan repayment provisions, health care professionals would not only need to complete specialty training in geriatrics or gerontology but also agree to provide full-time clinical practice and service to older adults for a minimum of 2 years.

In addition, the bill would expand eligibility for the Nursing Education Loan Repayment Program to include registered nurses who complete specialty training and provide nursing services to older adults in long-term care settings.

The proposed law also would expand midcareer specialty training in long-term care services through an existing training-grant program.

Sen. Boxer also proposes creation of a Health and Long-Term Care Workforce Advisory Panel for an Aging America, which would advise federal policy makers on workforce issues related to long-term care for the country's aging population.

“The medical and health community is already struggling to meet the demand for geriatric health care and support services, and the need for trained professionals is only growing,” Sen. Boxer said in a statement. “This legislation will provide incentives to help encourage qualified practitioners to join the geriatrics and gerontology fields.”

At press time, AMDA's Public Policy Committee was reviewing the actual legislation, which Kathleen M. Wilson, the group's director of government affairs, said is made up of initiatives closely similar to the concepts endorsed last year.

The loan guarantees in the legislation could be worth up to $150,000 for a professional who provides full-time health care to older adults for 4 years.

“That's fairly substantial, and it has to be substantial to get peoples' attention,” Dr. Katz said. “That's something I've been preaching for a while.”

However, Dr. Katz also warned that the bill needs to better define “geriatric providers” for the purposes of the legislation's financial aid, especially non-physician providers.

“Right now, for physicians there's a formal process of being trained in geriatrics, so it's not an issue. But for social workers and therapists, there aren't always specialty courses.”

Dr. Katz also noted that the bill is not specific to long-term care. “It's focusing on geriatricians,” he said.

“What about people who want to practice in long-term care?” Overall, though, Dr. Katz said he supports the legislation.

Sen. Barbara Boxer (D-Calif.) has introduced legislation aimed at addressing the potential crisis in providing care for elderly Americans.

The bill, introduced in March, seeks to offer a combination of educational-loan forgiveness and career-advancement opportunities for health care professionals choosing practice in nursing homes.

The Caring for an Aging America Act, S. 2708, would have the federal government provide $130 million over 5 years to benefit physicians, physician assistants, advance practice nurses, psychologists, and social workers choosing geriatrics and gerontology.

Aid would come primarily through educational loan repayments for these professionals. The bill already has been endorsed by the American Geriatrics Society, the National Council on Aging, the National Association of Geriatric Education, the Alzheimer's Association, and the National Association of Social Workers.

The American Medical Directors Association (AMDA), which represents nursing facility practitioners, has approved the bill's concepts in principle. “I think overall, this really is a big step forward,” said Dr. Paul Katz, AMDA vice president and chief of geriatrics at the University of Rochester, N.Y.

To benefit from the loan repayment provisions, health care professionals would not only need to complete specialty training in geriatrics or gerontology but also agree to provide full-time clinical practice and service to older adults for a minimum of 2 years.

In addition, the bill would expand eligibility for the Nursing Education Loan Repayment Program to include registered nurses who complete specialty training and provide nursing services to older adults in long-term care settings.

The proposed law also would expand midcareer specialty training in long-term care services through an existing training-grant program.

Sen. Boxer also proposes creation of a Health and Long-Term Care Workforce Advisory Panel for an Aging America, which would advise federal policy makers on workforce issues related to long-term care for the country's aging population.

“The medical and health community is already struggling to meet the demand for geriatric health care and support services, and the need for trained professionals is only growing,” Sen. Boxer said in a statement. “This legislation will provide incentives to help encourage qualified practitioners to join the geriatrics and gerontology fields.”

At press time, AMDA's Public Policy Committee was reviewing the actual legislation, which Kathleen M. Wilson, the group's director of government affairs, said is made up of initiatives closely similar to the concepts endorsed last year.

The loan guarantees in the legislation could be worth up to $150,000 for a professional who provides full-time health care to older adults for 4 years.

“That's fairly substantial, and it has to be substantial to get peoples' attention,” Dr. Katz said. “That's something I've been preaching for a while.”

However, Dr. Katz also warned that the bill needs to better define “geriatric providers” for the purposes of the legislation's financial aid, especially non-physician providers.

“Right now, for physicians there's a formal process of being trained in geriatrics, so it's not an issue. But for social workers and therapists, there aren't always specialty courses.”

Dr. Katz also noted that the bill is not specific to long-term care. “It's focusing on geriatricians,” he said.

“What about people who want to practice in long-term care?” Overall, though, Dr. Katz said he supports the legislation.

Sen. Barbara Boxer (D-Calif.) has introduced legislation aimed at addressing the potential crisis in providing care for elderly Americans. The bill offers a combination of educational-loan forgiveness and career-advancement opportunities for health care professionals choosing practice in nursing homes.

The Caring for an Aging America Act, S. 2708, would have the federal government provide $130 million over 5 years to benefit physicians, physician assistants, advance practice nurses, psychologists, and social workers choosing geriatrics and gerontology. Aid would come primarily through educational loan repayments for these professionals. The bill already has been endorsed by the American Geriatrics Society, the National Council on Aging, the National Association of Geriatric Education, the Alzheimer's Association, and the National Association of Social Workers.

The American Medical Directors Association (AMDA), which represents nursing facility practitioners, has approved the bill's concepts in principle. “I'm very positive on the bill,” said Dr. Paul Katz, AMDA vice president and chief of geriatrics at the University of Rochester, N.Y. “I think overall, this really is a big step forward.”

To benefit from the loan repayment provisions, health care professionals would not only need to complete specialty training in geriatrics or gerontology but also agree to provide full-time clinical practice and service to older adults for a minimum of 2 years. In addition, the bill would expand eligibility for the Nursing Education Loan Repayment Program to include registered nurses who complete specialty training and provide nursing services to older adults in long-term care settings. The proposed law also would expand midcareer specialty training in long-term care services through an existing training-grant program.

Sen. Boxer also proposes creation of a Health and Long-Term Care Workforce Advisory Panel for an Aging America, which would advise federal policy makers on workforce issues related to long-term care for the country's aging population.

“The medical and health community is already struggling to meet the demand for geriatric health care and support services, and the need for trained professionals is only growing,” said Sen. Boxer in a statement. “This legislation will provide incentives to help encourage qualified practitioners to join the geriatrics and gerontology fields.”

AMDA's director of government affairs Kathleen M. Wilson said that the association supports the concepts included in the legislation, based on a draft that Sen. Boxer's staff provided last year. At press time, AMDA's Public Policy Committee was reviewing the actual legislation, which Ms. Wilson said is made up of initiatives closely similar to the concepts endorsed last year.

The loan guarantees in the legislation could be worth up to $150,000 for a professional who provides full-time health care to older adults for 4 years. “That's fairly substantial, and it has to be substantial to get peoples' attention,” said Dr. Katz. “That's something I've been preaching for awhile.”

However, Dr. Katz also warned that the bill needs to better define the term “geriatric providers” for the purposes of the legislation's financial aid, especially nonphysician providers. “Right now, for physicians there's a formal process of being trained in geriatrics, so it's not an issue. But for social workers and therapists, there aren't always specialty courses.”

And, he added, the bill needs to specify what kinds of courses would qualify.

Dr. Katz also noted that the bill isn't specific to long-term care. “It's focusing on geriatricians,” he said. “What about people who want to practice in long-term care?”

Overall, though, Dr. Katz said he supports S. 2708.

Sen. Barbara Boxer (D-Calif.) has introduced legislation aimed at addressing the potential crisis in providing care for elderly Americans. The bill offers a combination of educational-loan forgiveness and career-advancement opportunities for health care professionals choosing practice in nursing homes.

The Caring for an Aging America Act, S. 2708, would have the federal government provide $130 million over 5 years to benefit physicians, physician assistants, advance practice nurses, psychologists, and social workers choosing geriatrics and gerontology. Aid would come primarily through educational loan repayments for these professionals. The bill already has been endorsed by the American Geriatrics Society, the National Council on Aging, the National Association of Geriatric Education, the Alzheimer's Association, and the National Association of Social Workers.

The American Medical Directors Association (AMDA), which represents nursing facility practitioners, has approved the bill's concepts in principle. “I'm very positive on the bill,” said Dr. Paul Katz, AMDA vice president and chief of geriatrics at the University of Rochester, N.Y. “I think overall, this really is a big step forward.”

To benefit from the loan repayment provisions, health care professionals would not only need to complete specialty training in geriatrics or gerontology but also agree to provide full-time clinical practice and service to older adults for a minimum of 2 years. In addition, the bill would expand eligibility for the Nursing Education Loan Repayment Program to include registered nurses who complete specialty training and provide nursing services to older adults in long-term care settings. The proposed law also would expand midcareer specialty training in long-term care services through an existing training-grant program.

Sen. Boxer also proposes creation of a Health and Long-Term Care Workforce Advisory Panel for an Aging America, which would advise federal policy makers on workforce issues related to long-term care for the country's aging population.

“The medical and health community is already struggling to meet the demand for geriatric health care and support services, and the need for trained professionals is only growing,” said Sen. Boxer in a statement. “This legislation will provide incentives to help encourage qualified practitioners to join the geriatrics and gerontology fields.”

AMDA's director of government affairs Kathleen M. Wilson said that the association supports the concepts included in the legislation, based on a draft that Sen. Boxer's staff provided last year. At press time, AMDA's Public Policy Committee was reviewing the actual legislation, which Ms. Wilson said is made up of initiatives closely similar to the concepts endorsed last year.

The loan guarantees in the legislation could be worth up to $150,000 for a professional who provides full-time health care to older adults for 4 years. “That's fairly substantial, and it has to be substantial to get peoples' attention,” said Dr. Katz. “That's something I've been preaching for awhile.”

However, Dr. Katz also warned that the bill needs to better define the term “geriatric providers” for the purposes of the legislation's financial aid, especially nonphysician providers. “Right now, for physicians there's a formal process of being trained in geriatrics, so it's not an issue. But for social workers and therapists, there aren't always specialty courses.”

And, he added, the bill needs to specify what kinds of courses would qualify.

Dr. Katz also noted that the bill isn't specific to long-term care. “It's focusing on geriatricians,” he said. “What about people who want to practice in long-term care?”

Overall, though, Dr. Katz said he supports S. 2708.

Sen. Barbara Boxer (D-Calif.) has introduced legislation aimed at addressing the potential crisis in providing care for elderly Americans. The bill offers a combination of educational-loan forgiveness and career-advancement opportunities for health care professionals choosing practice in nursing homes.

The Caring for an Aging America Act, S. 2708, would have the federal government provide $130 million over 5 years to benefit physicians, physician assistants, advance practice nurses, psychologists, and social workers choosing geriatrics and gerontology. Aid would come primarily through educational loan repayments for these professionals. The bill already has been endorsed by the American Geriatrics Society, the National Council on Aging, the National Association of Geriatric Education, the Alzheimer's Association, and the National Association of Social Workers.

The American Medical Directors Association (AMDA), which represents nursing facility practitioners, has approved the bill's concepts in principle. “I'm very positive on the bill,” said Dr. Paul Katz, AMDA vice president and chief of geriatrics at the University of Rochester, N.Y. “I think overall, this really is a big step forward.”

To benefit from the loan repayment provisions, health care professionals would not only need to complete specialty training in geriatrics or gerontology but also agree to provide full-time clinical practice and service to older adults for a minimum of 2 years. In addition, the bill would expand eligibility for the Nursing Education Loan Repayment Program to include registered nurses who complete specialty training and provide nursing services to older adults in long-term care settings. The proposed law also would expand midcareer specialty training in long-term care services through an existing training-grant program.

Sen. Boxer also proposes creation of a Health and Long-Term Care Workforce Advisory Panel for an Aging America, which would advise federal policy makers on workforce issues related to long-term care for the country's aging population.

“The medical and health community is already struggling to meet the demand for geriatric health care and support services, and the need for trained professionals is only growing,” said Sen. Boxer in a statement. “This legislation will provide incentives to help encourage qualified practitioners to join the geriatrics and gerontology fields.”

AMDA's director of government affairs Kathleen M. Wilson said that the association supports the concepts included in the legislation, based on a draft that Sen. Boxer's staff provided last year. At press time, AMDA's Public Policy Committee was reviewing the actual legislation, which Ms. Wilson said is made up of initiatives closely similar to the concepts endorsed last year.

The loan guarantees in the legislation could be worth up to $150,000 for a professional who provides full-time health care to older adults for 4 years. “That's fairly substantial, and it has to be substantial to get peoples' attention,” said Dr. Katz. “That's something I've been preaching for awhile.”

However, Dr. Katz also warned that the bill needs to better define the term “geriatric providers” for the purposes of the legislation's financial aid, especially nonphysician providers. “Right now, for physicians there's a formal process of being trained in geriatrics, so it's not an issue. But for social workers and therapists, there aren't always specialty courses.”

And, he added, the bill needs to specify what kinds of courses would qualify.

Dr. Katz also noted that the bill isn't specific to long-term care. “It's focusing on geriatricians,” he said. “What about people who want to practice in long-term care?”

Overall, though, Dr. Katz said he supports S. 2708.

Ga. Docs Collaborate on EHRs

Georgia physicians are collaborating with the state's Department of Community Health on adoption of Medicare electronic health records, the department said. The department intends to apply to the Centers for Medicare and Medicaid Services to participate in an EHR demonstration project, and department officials said they met with Georgia physicians in March to develop the program. Over a 5-year period, the demonstration project will provide financial incentives to small and medium-size physician groups using certified EHRs to meet certain clinical measures. Bonuses will be provided each year, based on a physician group's score on a standardized survey that assesses the specific EHR functions a group employs to support the delivery of care.

Consumer-Directed Enrollment Low

More employers are offering consumer-directed health plans in efforts to shift greater responsibility to workers for health care costs, lifestyle choices, and treatment decisions, according to a new survey on the plans. However, enrollment still constitutes only a small percentage of those enrolled in all employer-sponsored health plans, because large employers have not yet structured their premium contributions to favor the consumer-directed options, according to the survey from the Center for Studying Health System Change. Survey respondents were optimistic that consumer-directed health plans would become more prominent in health benefit offerings, but the report said plans and employers seeking to foster greater enrollment may need to make health savings accounts and health reimbursement arrangements more appealing to enrollees.

MA, Part D Changes Announced

The out-of-pocket threshold for a beneficiary enrolled in a standard Medicare Part D drug plan will rise from $4,050 to $4,350 next year, while the initial deductible rises from $275 to $295, CMS announced. The out-of-pocket threshold is the point at which the Part D “doughnut hole” is satisfied and Medicare begins paying for most drug expenses, minus 5% copayments. At the same time, health insurers running Medicare Advantage plans will see average increases of about 3.6% in capitation rates in 2009, CMS said. This increase in capitation rates is slightly lower than the estimated 3.7% Medicare growth trend for 2009, CMS said. In addition, CMS said it will audit records from a sample of Medicare Advantage plans in an effort to determine if the plans are reporting diagnosis code information correctly. Diagnosis code information is used in setting capitation and payment rates for the plans.

Workers Struggle With Health Costs

Almost all of those polled in a recent AFL-CIO survey said they were struggling with the cost of health care, even though most were insured and employed and more than half were in union jobs or were college graduates. One-third of respondents to the online survey, sponsored by the AFL-CIO and Working America, reported skipping medical care because of cost, and one-quarter had serious problems paying for the care they needed. In the past year, 76% of people who lacked insurance themselves and 71% of people with uninsured children said someone in their family did not visit a doctor when sick because of cost. In addition, about two-thirds of those without insurance reported skipping medical treatment or follow-up care, and more than half said they had to choose between paying for medical care or prescriptions and other essential needs, such as the rent, mortgage, or utilities. Nearly four out of five said health care is a very important voting issue.

Side Effects Underreported

One in six Americans who have taken a prescription drug experienced a side effect serious enough to send them to the doctor or hospital, but only 35% of consumers said they know they can report these side effects to the FDA, according to a Consumer Reports poll. Additionally, 81% of respondents said they had seen or heard an ad for prescription drugs within the last 30 days, almost all on television. Consumers Union, the nonprofit publisher of the magazine, gave the FDA a petition signed by nearly 56,000 consumers asking that a toll-free number and Web site be included in all television drug ads so people can easily report their serious side effects. “What better way for the FDA to let consumers know how to report serious problems with their medications than putting a toll-free number and Web site in all those drug ads we're bombarded by each day?” asked Liz Foley, campaign coordinator with Consumers Union, in a statement.

AAMC Adopts Medical Home

The Association of American Medical Colleges has adopted a formal position stating that every person should have access to a medical home. “We believe the medical home model holds great promise for improving Americans' health by ensuring that they have an ongoing relationship with a trusted medical professional,” Dr. Darrell Kirch, AAMD president and CEO, said in a statement. The AAMC position also said that further research and evaluation of the medical home model is needed and more evidence must be gathered on how the model is best implemented. In addition, payment for the model should “appropriately recognize and reward providers for prevention, care delivery, and coordination,” and “health care providers should be trained to understand and implement the medical home model within a team environment,” the AAMC said.

Ga. Docs Collaborate on EHRs

Georgia physicians are collaborating with the state's Department of Community Health on adoption of Medicare electronic health records, the department said. The department intends to apply to the Centers for Medicare and Medicaid Services to participate in an EHR demonstration project, and department officials said they met with Georgia physicians in March to develop the program. Over a 5-year period, the demonstration project will provide financial incentives to small and medium-size physician groups using certified EHRs to meet certain clinical measures. Bonuses will be provided each year, based on a physician group's score on a standardized survey that assesses the specific EHR functions a group employs to support the delivery of care.

Consumer-Directed Enrollment Low

More employers are offering consumer-directed health plans in efforts to shift greater responsibility to workers for health care costs, lifestyle choices, and treatment decisions, according to a new survey on the plans. However, enrollment still constitutes only a small percentage of those enrolled in all employer-sponsored health plans, because large employers have not yet structured their premium contributions to favor the consumer-directed options, according to the survey from the Center for Studying Health System Change. Survey respondents were optimistic that consumer-directed health plans would become more prominent in health benefit offerings, but the report said plans and employers seeking to foster greater enrollment may need to make health savings accounts and health reimbursement arrangements more appealing to enrollees.

MA, Part D Changes Announced

The out-of-pocket threshold for a beneficiary enrolled in a standard Medicare Part D drug plan will rise from $4,050 to $4,350 next year, while the initial deductible rises from $275 to $295, CMS announced. The out-of-pocket threshold is the point at which the Part D “doughnut hole” is satisfied and Medicare begins paying for most drug expenses, minus 5% copayments. At the same time, health insurers running Medicare Advantage plans will see average increases of about 3.6% in capitation rates in 2009, CMS said. This increase in capitation rates is slightly lower than the estimated 3.7% Medicare growth trend for 2009, CMS said. In addition, CMS said it will audit records from a sample of Medicare Advantage plans in an effort to determine if the plans are reporting diagnosis code information correctly. Diagnosis code information is used in setting capitation and payment rates for the plans.

Workers Struggle With Health Costs

Almost all of those polled in a recent AFL-CIO survey said they were struggling with the cost of health care, even though most were insured and employed and more than half were in union jobs or were college graduates. One-third of respondents to the online survey, sponsored by the AFL-CIO and Working America, reported skipping medical care because of cost, and one-quarter had serious problems paying for the care they needed. In the past year, 76% of people who lacked insurance themselves and 71% of people with uninsured children said someone in their family did not visit a doctor when sick because of cost. In addition, about two-thirds of those without insurance reported skipping medical treatment or follow-up care, and more than half said they had to choose between paying for medical care or prescriptions and other essential needs, such as the rent, mortgage, or utilities. Nearly four out of five said health care is a very important voting issue.

Side Effects Underreported

One in six Americans who have taken a prescription drug experienced a side effect serious enough to send them to the doctor or hospital, but only 35% of consumers said they know they can report these side effects to the FDA, according to a Consumer Reports poll. Additionally, 81% of respondents said they had seen or heard an ad for prescription drugs within the last 30 days, almost all on television. Consumers Union, the nonprofit publisher of the magazine, gave the FDA a petition signed by nearly 56,000 consumers asking that a toll-free number and Web site be included in all television drug ads so people can easily report their serious side effects. “What better way for the FDA to let consumers know how to report serious problems with their medications than putting a toll-free number and Web site in all those drug ads we're bombarded by each day?” asked Liz Foley, campaign coordinator with Consumers Union, in a statement.

AAMC Adopts Medical Home

The Association of American Medical Colleges has adopted a formal position stating that every person should have access to a medical home. “We believe the medical home model holds great promise for improving Americans' health by ensuring that they have an ongoing relationship with a trusted medical professional,” Dr. Darrell Kirch, AAMD president and CEO, said in a statement. The AAMC position also said that further research and evaluation of the medical home model is needed and more evidence must be gathered on how the model is best implemented. In addition, payment for the model should “appropriately recognize and reward providers for prevention, care delivery, and coordination,” and “health care providers should be trained to understand and implement the medical home model within a team environment,” the AAMC said.

Ga. Docs Collaborate on EHRs

Georgia physicians are collaborating with the state's Department of Community Health on adoption of Medicare electronic health records, the department said. The department intends to apply to the Centers for Medicare and Medicaid Services to participate in an EHR demonstration project, and department officials said they met with Georgia physicians in March to develop the program. Over a 5-year period, the demonstration project will provide financial incentives to small and medium-size physician groups using certified EHRs to meet certain clinical measures. Bonuses will be provided each year, based on a physician group's score on a standardized survey that assesses the specific EHR functions a group employs to support the delivery of care.

Consumer-Directed Enrollment Low

More employers are offering consumer-directed health plans in efforts to shift greater responsibility to workers for health care costs, lifestyle choices, and treatment decisions, according to a new survey on the plans. However, enrollment still constitutes only a small percentage of those enrolled in all employer-sponsored health plans, because large employers have not yet structured their premium contributions to favor the consumer-directed options, according to the survey from the Center for Studying Health System Change. Survey respondents were optimistic that consumer-directed health plans would become more prominent in health benefit offerings, but the report said plans and employers seeking to foster greater enrollment may need to make health savings accounts and health reimbursement arrangements more appealing to enrollees.

MA, Part D Changes Announced

The out-of-pocket threshold for a beneficiary enrolled in a standard Medicare Part D drug plan will rise from $4,050 to $4,350 next year, while the initial deductible rises from $275 to $295, CMS announced. The out-of-pocket threshold is the point at which the Part D “doughnut hole” is satisfied and Medicare begins paying for most drug expenses, minus 5% copayments. At the same time, health insurers running Medicare Advantage plans will see average increases of about 3.6% in capitation rates in 2009, CMS said. This increase in capitation rates is slightly lower than the estimated 3.7% Medicare growth trend for 2009, CMS said. In addition, CMS said it will audit records from a sample of Medicare Advantage plans in an effort to determine if the plans are reporting diagnosis code information correctly. Diagnosis code information is used in setting capitation and payment rates for the plans.

Workers Struggle With Health Costs

Almost all of those polled in a recent AFL-CIO survey said they were struggling with the cost of health care, even though most were insured and employed and more than half were in union jobs or were college graduates. One-third of respondents to the online survey, sponsored by the AFL-CIO and Working America, reported skipping medical care because of cost, and one-quarter had serious problems paying for the care they needed. In the past year, 76% of people who lacked insurance themselves and 71% of people with uninsured children said someone in their family did not visit a doctor when sick because of cost. In addition, about two-thirds of those without insurance reported skipping medical treatment or follow-up care, and more than half said they had to choose between paying for medical care or prescriptions and other essential needs, such as the rent, mortgage, or utilities. Nearly four out of five said health care is a very important voting issue.

Side Effects Underreported

One in six Americans who have taken a prescription drug experienced a side effect serious enough to send them to the doctor or hospital, but only 35% of consumers said they know they can report these side effects to the FDA, according to a Consumer Reports poll. Additionally, 81% of respondents said they had seen or heard an ad for prescription drugs within the last 30 days, almost all on television. Consumers Union, the nonprofit publisher of the magazine, gave the FDA a petition signed by nearly 56,000 consumers asking that a toll-free number and Web site be included in all television drug ads so people can easily report their serious side effects. “What better way for the FDA to let consumers know how to report serious problems with their medications than putting a toll-free number and Web site in all those drug ads we're bombarded by each day?” asked Liz Foley, campaign coordinator with Consumers Union, in a statement.

AAMC Adopts Medical Home

The Association of American Medical Colleges has adopted a formal position stating that every person should have access to a medical home. “We believe the medical home model holds great promise for improving Americans' health by ensuring that they have an ongoing relationship with a trusted medical professional,” Dr. Darrell Kirch, AAMD president and CEO, said in a statement. The AAMC position also said that further research and evaluation of the medical home model is needed and more evidence must be gathered on how the model is best implemented. In addition, payment for the model should “appropriately recognize and reward providers for prevention, care delivery, and coordination,” and “health care providers should be trained to understand and implement the medical home model within a team environment,” the AAMC said.

In a move that sponsors believe is the first of its kind in the United States, attending general surgeons at several Boston-area hospitals will be required to prove basic motor skills outside an operating room before obtaining laparoscopic surgery privileges.

And as an incentive toward completion of the Fundamentals in Laparoscopic Surgery (FLS) exam, CRICO/RMF, the Harvard medical community's professional liability insurer, is providing a one-time $500 patient safety incentive to general surgeons who pass the exam.

The new requirement—which is going into effect at Beth Israel Deaconess Medical Center, Cambridge Health Alliance, and Massachusetts General Hospital, all of which are in Boston—could portend adoption of the FLS standards in many hospitals, said Dr. Steven Schwaitzberg, chief of surgery at the Cambridge Health Alliance.

“I expect it to spread,” Dr. Schwaitzberg said in an interview. “I think this is going to become quite viral in terms of its impact and rate of spread, and pick up dramatically.”

The FLS program, which includes hands-on skills training and assessment tools, took almost a decade to develop, and is a joint educational offering of the American College of Surgeons and the Society of Gastrointestinal and Endoscopic Surgeons.

The test is a two-part, proctored 75-question multiple choice exam administered by computer, plus an evaluation of skills based on speed and accuracy of the surgeon's maneuvers using the FLS Laparoscopic Trainer Box.

The skills test consists of five nonprocedure-specific simulation exercises incorporating most of the psychomotor skills necessary for basic laparoscopic surgery. Surgeons are tested on their proficiency at suturing, cutting in a circle, and moving objects from one location to another.

Beth Israel Deaconess was the first U.S. hospital to require general surgeons performing laparoscopic surgery to pass the FLS exam, said Dr. Daniel Jones, the hospital's chief of minimally invasive surgery.

The hospital started requiring residents to prove competency in laparoscopy about 10 years ago, Dr. Jones said in an interview. “Finally we said: Why should we hold trainees to a higher level than surgeons in practice? Would you let a truck driver drive after only a written exam?”

Dr. Jones said surgeons can elect to simply take the test without taking the course first. “I did that,” he said. “But it's a real test, and it's better to study and practice first. It's nothing less than a patient would expect their surgeon to do effortlessly.”

In the Boston area, professional liability insurer CRICO/RMF sponsored the FLS course in January, and about 60 people signed up, said Dr. Schwaitzberg. Beth Israel Deaconess and Cambridge Health Alliance have already adopted the FLS exam as a requirement for laparoscopic privileges, and Massachusetts General Hospital will do so in the near future, said Dr. David Rattner, chief of the division of general and gastrointestinal surgery at Massachusetts General.

Surgeons insured by CRICO/RMF who pass the exam will receive a one-time $500 patient safety incentive from the insurer, as well as continuing medical education credits through SAGES and ACS. But “it's not about the money,” said Dr. Jones. “It's about sending the signal that the bar has been raised.”

Dr. Jones said he expects the FLS to become the new minimal standard for all surgeons offering basic laparoscopy to patients. And Dr. Schwaitzberg agreed, saying the FLS, like the Advanced Trauma Life Support (ATLS) curriculum in trauma surgery, indicates a move toward more testing of skills and competency in surgery in general.

“You wouldn't work in a trauma [emergency department] without the ATLS,” said Dr. Schwaitzberg. “Will this be a model for other aspects of surgery? I think so.”

In a move that sponsors believe is the first of its kind in the United States, attending general surgeons at several Boston-area hospitals will be required to prove basic motor skills outside an operating room before obtaining laparoscopic surgery privileges.

And as an incentive toward completion of the Fundamentals in Laparoscopic Surgery (FLS) exam, CRICO/RMF, the Harvard medical community's professional liability insurer, is providing a one-time $500 patient safety incentive to general surgeons who pass the exam.

The new requirement—which is going into effect at Beth Israel Deaconess Medical Center, Cambridge Health Alliance, and Massachusetts General Hospital, all of which are in Boston—could portend adoption of the FLS standards in many hospitals, said Dr. Steven Schwaitzberg, chief of surgery at the Cambridge Health Alliance.

“I expect it to spread,” Dr. Schwaitzberg said in an interview. “I think this is going to become quite viral in terms of its impact and rate of spread, and pick up dramatically.”

The FLS program, which includes hands-on skills training and assessment tools, took almost a decade to develop, and is a joint educational offering of the American College of Surgeons and the Society of Gastrointestinal and Endoscopic Surgeons.

The test is a two-part, proctored 75-question multiple choice exam administered by computer, plus an evaluation of skills based on speed and accuracy of the surgeon's maneuvers using the FLS Laparoscopic Trainer Box.

The skills test consists of five nonprocedure-specific simulation exercises incorporating most of the psychomotor skills necessary for basic laparoscopic surgery. Surgeons are tested on their proficiency at suturing, cutting in a circle, and moving objects from one location to another.

Beth Israel Deaconess was the first U.S. hospital to require general surgeons performing laparoscopic surgery to pass the FLS exam, said Dr. Daniel Jones, the hospital's chief of minimally invasive surgery.

The hospital started requiring residents to prove competency in laparoscopy about 10 years ago, Dr. Jones said in an interview. “Finally we said: Why should we hold trainees to a higher level than surgeons in practice? Would you let a truck driver drive after only a written exam?”

Dr. Jones said surgeons can elect to simply take the test without taking the course first. “I did that,” he said. “But it's a real test, and it's better to study and practice first. It's nothing less than a patient would expect their surgeon to do effortlessly.”

In the Boston area, professional liability insurer CRICO/RMF sponsored the FLS course in January, and about 60 people signed up, said Dr. Schwaitzberg. Beth Israel Deaconess and Cambridge Health Alliance have already adopted the FLS exam as a requirement for laparoscopic privileges, and Massachusetts General Hospital will do so in the near future, said Dr. David Rattner, chief of the division of general and gastrointestinal surgery at Massachusetts General.

Surgeons insured by CRICO/RMF who pass the exam will receive a one-time $500 patient safety incentive from the insurer, as well as continuing medical education credits through SAGES and ACS. But “it's not about the money,” said Dr. Jones. “It's about sending the signal that the bar has been raised.”

Dr. Jones said he expects the FLS to become the new minimal standard for all surgeons offering basic laparoscopy to patients. And Dr. Schwaitzberg agreed, saying the FLS, like the Advanced Trauma Life Support (ATLS) curriculum in trauma surgery, indicates a move toward more testing of skills and competency in surgery in general.

“You wouldn't work in a trauma [emergency department] without the ATLS,” said Dr. Schwaitzberg. “Will this be a model for other aspects of surgery? I think so.”

In a move that sponsors believe is the first of its kind in the United States, attending general surgeons at several Boston-area hospitals will be required to prove basic motor skills outside an operating room before obtaining laparoscopic surgery privileges.

And as an incentive toward completion of the Fundamentals in Laparoscopic Surgery (FLS) exam, CRICO/RMF, the Harvard medical community's professional liability insurer, is providing a one-time $500 patient safety incentive to general surgeons who pass the exam.

The new requirement—which is going into effect at Beth Israel Deaconess Medical Center, Cambridge Health Alliance, and Massachusetts General Hospital, all of which are in Boston—could portend adoption of the FLS standards in many hospitals, said Dr. Steven Schwaitzberg, chief of surgery at the Cambridge Health Alliance.

“I expect it to spread,” Dr. Schwaitzberg said in an interview. “I think this is going to become quite viral in terms of its impact and rate of spread, and pick up dramatically.”

The FLS program, which includes hands-on skills training and assessment tools, took almost a decade to develop, and is a joint educational offering of the American College of Surgeons and the Society of Gastrointestinal and Endoscopic Surgeons.

The test is a two-part, proctored 75-question multiple choice exam administered by computer, plus an evaluation of skills based on speed and accuracy of the surgeon's maneuvers using the FLS Laparoscopic Trainer Box.

The skills test consists of five nonprocedure-specific simulation exercises incorporating most of the psychomotor skills necessary for basic laparoscopic surgery. Surgeons are tested on their proficiency at suturing, cutting in a circle, and moving objects from one location to another.

Beth Israel Deaconess was the first U.S. hospital to require general surgeons performing laparoscopic surgery to pass the FLS exam, said Dr. Daniel Jones, the hospital's chief of minimally invasive surgery.

The hospital started requiring residents to prove competency in laparoscopy about 10 years ago, Dr. Jones said in an interview. “Finally we said: Why should we hold trainees to a higher level than surgeons in practice? Would you let a truck driver drive after only a written exam?”

Dr. Jones said surgeons can elect to simply take the test without taking the course first. “I did that,” he said. “But it's a real test, and it's better to study and practice first. It's nothing less than a patient would expect their surgeon to do effortlessly.”

In the Boston area, professional liability insurer CRICO/RMF sponsored the FLS course in January, and about 60 people signed up, said Dr. Schwaitzberg. Beth Israel Deaconess and Cambridge Health Alliance have already adopted the FLS exam as a requirement for laparoscopic privileges, and Massachusetts General Hospital will do so in the near future, said Dr. David Rattner, chief of the division of general and gastrointestinal surgery at Massachusetts General.

Surgeons insured by CRICO/RMF who pass the exam will receive a one-time $500 patient safety incentive from the insurer, as well as continuing medical education credits through SAGES and ACS. But “it's not about the money,” said Dr. Jones. “It's about sending the signal that the bar has been raised.”

Dr. Jones said he expects the FLS to become the new minimal standard for all surgeons offering basic laparoscopy to patients. And Dr. Schwaitzberg agreed, saying the FLS, like the Advanced Trauma Life Support (ATLS) curriculum in trauma surgery, indicates a move toward more testing of skills and competency in surgery in general.

“You wouldn't work in a trauma [emergency department] without the ATLS,” said Dr. Schwaitzberg. “Will this be a model for other aspects of surgery? I think so.”

Sen. Barbara Boxer (D-Calif.) introduced legislation in March aimed at addressing the potential crisis in providing care for elderly Americans. The bill offers a combination of educational-loan forgiveness and career-advancement opportunities for health care professionals choosing practice in nursing homes.

The Caring for an Aging America Act, S. 2708, would have the federal government provide $130 million over 5 years to benefit physicians, physician assistants, advance practice nurses, psychologists, and social workers choosing geriatrics and gerontology. Aid would come primarily through educational loan repayments for these professionals in. The bill already has been endorsed by the American Geriatrics Society, the National Council on Aging, the National Association of Geriatric Education, the Alzheimer's Association, and the National Association of Social Workers.

The American Medical Directors Association (AMDA), which represents nursing facility practitioners, has approved the bill's concepts in principle. “I'm very positive on the bill,” said Dr. Paul Katz, AMDA vice president and chief of geriatrics at the University of Rochester (N.Y.). “I think overall, this really is a big step forward.”

To benefit from the loan repayment provisions, health care professionals would not only need to complete specialty training in geriatrics or gerontology but also agree to provide full-time clinical practice and service to older adults for a minimum of 2 years. In addition, the bill would expand eligibility for the Nursing Education Loan Repayment Program to include registered nurses who complete specialty training and provide nursing services to older adults in long-term care settings. The proposed law also would expand midcareer specialty training in long-term care services through an existing training-grant program.

Sen. Boxer also proposes creation of a Health and Long-Term Care Workforce Advisory Panel for an Aging America, which would advise federal policy makers on workforce issues related to long-term care for the country's aging population.

“The medical and health community is already struggling to meet the demand for geriatric health care and support services, and the need for trained professionals is only growing,” Sen. Boxer said in a statement. “This legislation will provide incentives to help encourage qualified practitioners to join the geriatrics and gerontology fields.”

Kathleen M. Wilson, AMDA's director of government affairs, said that the association supports the concepts included in the legislation, based on a draft that Sen. Boxer's staff provided last year. At press time, AMDA's public policy committee was reviewing the actual legislation, which Wilson said is made up of initiatives closely similar to the concepts endorsed last year.

The loan guarantees in the legislation could be worth up to $150,000 for a professional who provides full-time health care to older adults for 4 years. “That's fairly substantial, and it has to be substantial to get peoples' attention,” said Dr. Katz. “That's something I've been preaching for awhile.”

However, Dr. Katz also warned that the bill needs to better define “geriatric providers” for the purposes of the legislation's financial aid, especially nonphysician providers.

“Right now, for physicians there's a formal process of being trained in geriatrics, so it's not an issue. But for social workers and therapists, there aren't always specialty courses.” And, he added, the bill needs to specify what kinds of courses would qualify.

Dr. Katz also noted that the bill isn't specific to long-term care. “It's focusing on geriatricians,” he said. “What about people who want to practice in long-term care?”

Overall, though, Dr. Katz said he supports S. 2708.

Sen. Barbara Boxer (D-Calif.) introduced legislation in March aimed at addressing the potential crisis in providing care for elderly Americans. The bill offers a combination of educational-loan forgiveness and career-advancement opportunities for health care professionals choosing practice in nursing homes.

The Caring for an Aging America Act, S. 2708, would have the federal government provide $130 million over 5 years to benefit physicians, physician assistants, advance practice nurses, psychologists, and social workers choosing geriatrics and gerontology. Aid would come primarily through educational loan repayments for these professionals in. The bill already has been endorsed by the American Geriatrics Society, the National Council on Aging, the National Association of Geriatric Education, the Alzheimer's Association, and the National Association of Social Workers.

The American Medical Directors Association (AMDA), which represents nursing facility practitioners, has approved the bill's concepts in principle. “I'm very positive on the bill,” said Dr. Paul Katz, AMDA vice president and chief of geriatrics at the University of Rochester (N.Y.). “I think overall, this really is a big step forward.”

To benefit from the loan repayment provisions, health care professionals would not only need to complete specialty training in geriatrics or gerontology but also agree to provide full-time clinical practice and service to older adults for a minimum of 2 years. In addition, the bill would expand eligibility for the Nursing Education Loan Repayment Program to include registered nurses who complete specialty training and provide nursing services to older adults in long-term care settings. The proposed law also would expand midcareer specialty training in long-term care services through an existing training-grant program.

Sen. Boxer also proposes creation of a Health and Long-Term Care Workforce Advisory Panel for an Aging America, which would advise federal policy makers on workforce issues related to long-term care for the country's aging population.

“The medical and health community is already struggling to meet the demand for geriatric health care and support services, and the need for trained professionals is only growing,” Sen. Boxer said in a statement. “This legislation will provide incentives to help encourage qualified practitioners to join the geriatrics and gerontology fields.”

Kathleen M. Wilson, AMDA's director of government affairs, said that the association supports the concepts included in the legislation, based on a draft that Sen. Boxer's staff provided last year. At press time, AMDA's public policy committee was reviewing the actual legislation, which Wilson said is made up of initiatives closely similar to the concepts endorsed last year.

The loan guarantees in the legislation could be worth up to $150,000 for a professional who provides full-time health care to older adults for 4 years. “That's fairly substantial, and it has to be substantial to get peoples' attention,” said Dr. Katz. “That's something I've been preaching for awhile.”

However, Dr. Katz also warned that the bill needs to better define “geriatric providers” for the purposes of the legislation's financial aid, especially nonphysician providers.

“Right now, for physicians there's a formal process of being trained in geriatrics, so it's not an issue. But for social workers and therapists, there aren't always specialty courses.” And, he added, the bill needs to specify what kinds of courses would qualify.

Dr. Katz also noted that the bill isn't specific to long-term care. “It's focusing on geriatricians,” he said. “What about people who want to practice in long-term care?”

Overall, though, Dr. Katz said he supports S. 2708.

Sen. Barbara Boxer (D-Calif.) introduced legislation in March aimed at addressing the potential crisis in providing care for elderly Americans. The bill offers a combination of educational-loan forgiveness and career-advancement opportunities for health care professionals choosing practice in nursing homes.

The Caring for an Aging America Act, S. 2708, would have the federal government provide $130 million over 5 years to benefit physicians, physician assistants, advance practice nurses, psychologists, and social workers choosing geriatrics and gerontology. Aid would come primarily through educational loan repayments for these professionals in. The bill already has been endorsed by the American Geriatrics Society, the National Council on Aging, the National Association of Geriatric Education, the Alzheimer's Association, and the National Association of Social Workers.

The American Medical Directors Association (AMDA), which represents nursing facility practitioners, has approved the bill's concepts in principle. “I'm very positive on the bill,” said Dr. Paul Katz, AMDA vice president and chief of geriatrics at the University of Rochester (N.Y.). “I think overall, this really is a big step forward.”

To benefit from the loan repayment provisions, health care professionals would not only need to complete specialty training in geriatrics or gerontology but also agree to provide full-time clinical practice and service to older adults for a minimum of 2 years. In addition, the bill would expand eligibility for the Nursing Education Loan Repayment Program to include registered nurses who complete specialty training and provide nursing services to older adults in long-term care settings. The proposed law also would expand midcareer specialty training in long-term care services through an existing training-grant program.

Sen. Boxer also proposes creation of a Health and Long-Term Care Workforce Advisory Panel for an Aging America, which would advise federal policy makers on workforce issues related to long-term care for the country's aging population.

“The medical and health community is already struggling to meet the demand for geriatric health care and support services, and the need for trained professionals is only growing,” Sen. Boxer said in a statement. “This legislation will provide incentives to help encourage qualified practitioners to join the geriatrics and gerontology fields.”

Kathleen M. Wilson, AMDA's director of government affairs, said that the association supports the concepts included in the legislation, based on a draft that Sen. Boxer's staff provided last year. At press time, AMDA's public policy committee was reviewing the actual legislation, which Wilson said is made up of initiatives closely similar to the concepts endorsed last year.

The loan guarantees in the legislation could be worth up to $150,000 for a professional who provides full-time health care to older adults for 4 years. “That's fairly substantial, and it has to be substantial to get peoples' attention,” said Dr. Katz. “That's something I've been preaching for awhile.”

However, Dr. Katz also warned that the bill needs to better define “geriatric providers” for the purposes of the legislation's financial aid, especially nonphysician providers.

“Right now, for physicians there's a formal process of being trained in geriatrics, so it's not an issue. But for social workers and therapists, there aren't always specialty courses.” And, he added, the bill needs to specify what kinds of courses would qualify.

Dr. Katz also noted that the bill isn't specific to long-term care. “It's focusing on geriatricians,” he said. “What about people who want to practice in long-term care?”

Overall, though, Dr. Katz said he supports S. 2708.