Jane Anderson

First-year enrollment in U.S. medical schools is projected to increase 17% over the next 5 years to nearly 19,300 students, helping to ameliorate the real need for new physicians, according to an annual survey of medical-school expansion plans released by the Association of American Medical Colleges.

The estimated expansion would move U.S. medical schools to the halfway point of a 30% enrollment increase recommended by the AAMC in 2006.

However, a top official at the American Academy of Family Physicians said that although adding additional medical school slots is laudable, the real emphasis needs to be placed on creating more primary care physicians.

“We certainly agree that the aging population and expansion of the nation is going to result in an expanding need for health care services,” said Dr. Perry Pugno, director of the division of medical education for AAFP.

“But it's not just a need for more doctors,” Dr. Pugno said. “We need more primary care physicians, especially family medicine doctors, to bring efficiency, cost-effectiveness, and better outcomes to the system.”

The survey of 121 out of 125 U.S. medical-school deans took place last fall, and the information gathered was compared with that of the baseline academic year of 2002–2003, when first-year enrollment totaled 16,488 students.

Survey results indicated that total first-year enrollment in existing U.S. medical schools is projected to increase by 2,558 students (15.5%) by 2012. Three-quarters of existing medical schools anticipate an increase, compared with 2002 enrollment levels.

However, the report notes that many of these planned increases depend upon state support or other outside funding sources. Projected enrollment for new medical schools accounts for an additional 1.5% percent of the total 17% expansion.

According to the survey, existing U.S. medical schools that are expanding will do so through a variety of mechanisms, including new clinical affiliations, expansion of existing campuses, and new regional or branch campuses.

Respondents also listed several barriers to enrollment increases, including the cost of such expansion, limited scholarship availability, tight classroom space, and too few ambulatory preceptors.

A smaller number of schools reported a lack of basic science faculty, low numbers or variety of patients, problems with regulatory or accreditation requirements, and poor quality applicants as major barriers.

ELSEVIER GLOBAL MEDICAL NEWS

First-year enrollment in U.S. medical schools is projected to increase 17% over the next 5 years to nearly 19,300 students, helping to ameliorate the real need for new physicians, according to an annual survey of medical-school expansion plans released by the Association of American Medical Colleges.

The estimated expansion would move U.S. medical schools to the halfway point of a 30% enrollment increase recommended by the AAMC in 2006.

However, a top official at the American Academy of Family Physicians said that although adding additional medical school slots is laudable, the real emphasis needs to be placed on creating more primary care physicians.

“We certainly agree that the aging population and expansion of the nation is going to result in an expanding need for health care services,” said Dr. Perry Pugno, director of the division of medical education for AAFP.

“But it's not just a need for more doctors,” Dr. Pugno said. “We need more primary care physicians, especially family medicine doctors, to bring efficiency, cost-effectiveness, and better outcomes to the system.”

The survey of 121 out of 125 U.S. medical-school deans took place last fall, and the information gathered was compared with that of the baseline academic year of 2002–2003, when first-year enrollment totaled 16,488 students.

Survey results indicated that total first-year enrollment in existing U.S. medical schools is projected to increase by 2,558 students (15.5%) by 2012. Three-quarters of existing medical schools anticipate an increase, compared with 2002 enrollment levels.

However, the report notes that many of these planned increases depend upon state support or other outside funding sources. Projected enrollment for new medical schools accounts for an additional 1.5% percent of the total 17% expansion.

According to the survey, existing U.S. medical schools that are expanding will do so through a variety of mechanisms, including new clinical affiliations, expansion of existing campuses, and new regional or branch campuses.

Respondents also listed several barriers to enrollment increases, including the cost of such expansion, limited scholarship availability, tight classroom space, and too few ambulatory preceptors.

A smaller number of schools reported a lack of basic science faculty, low numbers or variety of patients, problems with regulatory or accreditation requirements, and poor quality applicants as major barriers.

ELSEVIER GLOBAL MEDICAL NEWS

First-year enrollment in U.S. medical schools is projected to increase 17% over the next 5 years to nearly 19,300 students, helping to ameliorate the real need for new physicians, according to an annual survey of medical-school expansion plans released by the Association of American Medical Colleges.

The estimated expansion would move U.S. medical schools to the halfway point of a 30% enrollment increase recommended by the AAMC in 2006.

However, a top official at the American Academy of Family Physicians said that although adding additional medical school slots is laudable, the real emphasis needs to be placed on creating more primary care physicians.

“We certainly agree that the aging population and expansion of the nation is going to result in an expanding need for health care services,” said Dr. Perry Pugno, director of the division of medical education for AAFP.

“But it's not just a need for more doctors,” Dr. Pugno said. “We need more primary care physicians, especially family medicine doctors, to bring efficiency, cost-effectiveness, and better outcomes to the system.”

The survey of 121 out of 125 U.S. medical-school deans took place last fall, and the information gathered was compared with that of the baseline academic year of 2002–2003, when first-year enrollment totaled 16,488 students.

Survey results indicated that total first-year enrollment in existing U.S. medical schools is projected to increase by 2,558 students (15.5%) by 2012. Three-quarters of existing medical schools anticipate an increase, compared with 2002 enrollment levels.

However, the report notes that many of these planned increases depend upon state support or other outside funding sources. Projected enrollment for new medical schools accounts for an additional 1.5% percent of the total 17% expansion.

According to the survey, existing U.S. medical schools that are expanding will do so through a variety of mechanisms, including new clinical affiliations, expansion of existing campuses, and new regional or branch campuses.

Respondents also listed several barriers to enrollment increases, including the cost of such expansion, limited scholarship availability, tight classroom space, and too few ambulatory preceptors.

A smaller number of schools reported a lack of basic science faculty, low numbers or variety of patients, problems with regulatory or accreditation requirements, and poor quality applicants as major barriers.

ELSEVIER GLOBAL MEDICAL NEWS

Docs Abuse Tax System

Thousands of Medicare Part B physicians, health professionals, and suppliers abused the federal tax system with little consequence, an analysis from the Government Accounting Office found. More than 21,000 Medicare Part B providers—about 5% of the total—had tax debts totaling more than $1 billion, mainly individual income and payroll taxes. Sen. Norm Coleman (R-Minn.), ranking member of the Permanent Subcommittee on Investigations, is using the report to press the Centers for Medicare and Medicaid Services to adopt the federal levy system, which would allow the Internal Revenue Service and the Treasury Department to tap into Medicare payments to providers in order to cover back taxes. “This is a classic case of the right hand not knowing what the left hand is doing,” Sen. Coleman said in a statement, noting that the federal government could have collected between $50 million and $140 million in 2005 if CMS had participated in the levy program. Medicare officials said at a hearing in March that they are working with the IRS and other agencies to manage payment policies.

Penalized by High-Deductible Plans

High-deductible health insurance plans discriminate against women by leaving them with far higher out-of-pocket health bills than men, according to a study from Harvard Medical School, Boston. The study also found that adults aged 45–64 years, those with any chronic condition such as asthma or high blood pressure, and children taking even one medication were likely to suffer financially in high-deductible plans. Under the plans, patients must pay at least $1,050 before their health coverage kicks in. In 2006, the median cost of care (both insurance and out-of-pocket) for women aged 18–64 was $1,844, compared with $847 for men. For middle-aged adults, the mean expenditure was $1,849 for men and $2,871 for women. High blood pressure patients had a mean annual expenditure of $3,161, while diabetics taking at least one medication had a mean expenditure of $5,774. “Even common, mild problems like arthritis and high blood pressure make you a loser in a high deductible plan,” said Dr. David Himmelstein, study coauthor and an advocate of a single-payer system.

Retail Clinics Replacing PCPs

More than 1 in 10 retail medical clinic users said the clinics have mostly or completely replaced their primary care physicians for the types of treatments offered at such facilities, according to a study from Market Strategies Inc., a research firm. “Consumers are telling us in no uncertain terms that convenience is so critical to them that they will forego traditional primary care providers in exchange for access to the kind of quick and convenient basic care services offered by retail clinics,” said John Thomas, MSI vice president, in a statement. The MSI study also indicated that consumers who have used retail clinics are open to treatment for a wider range of conditions including migraine, dyslipidemia, and hypertension. In addition, 30% of all consumers polled said that the clinics should compete with primary care physicians by offering a broader variety of services. The American Academy of Family Physicians said in a February policy statement that retail clinics should have a “well-defined and limited scope of clinical services,” and that they should encourage all patients to have a medical home.

Negotiation Could Save $30 Billion

Legislation that would allow Medicare to use its bulk purchasing power to negotiate for lower prescription drug prices under Part D could save U.S. taxpayers and seniors more than $30 billion annually, an advocacy group reported. The Institute for American Research said that about $10 billion of those savings would accrue to U.S. seniors in the form of cheaper prices, while the U.S. government could save roughly $20 billion a year by having Medicare negotiate for the same prices the Department of Veterans Affairs already gets. However, the Pharmaceutical Research and Manufacturers of America (PhRMA), which represents drug makers and opposes the legislation, said that pharmacy benefit managers already are negotiating with manufacturers for lower prices under Part D.

Cuts Would Harm Seniors

Three-fourths of physicians said they believe that seniors will be harmed if Congress cuts the Medicare Advantage program, and the vast majority of doctors said lawmakers should cut other programs or raise taxes rather than cut Medicare Advantage, according to the industry group America's Health Insurance Plans (AHIP). In addition, 35% of seniors enrolled in Medicare Advantage said they would skip some of the health care treatments they currently receive if the option of choosing a Medicare health plan is taken away. The findings are from two surveys released by AHIP in March.

Changing MD Demographics

A major demographic shift is underway in medicine as female physicians become more numerous, and this trend will influence the way medical groups recruit and retain physicians throughout their career cycles, according to the 2006 Retention Survey from the American Medical Group Association and Cejka Search, an executive search organization. In 2006, female physicians accounted for 35% of physicians employed in the medical groups responding to the survey, compared with 28% in the previous survey. The study revealed that factors such as “poor cultural fit” and family issues are the driving forces in physician turnover. Part-time and flexible work options also are growing in importance, the survey found.

Docs Abuse Tax System

Thousands of Medicare Part B physicians, health professionals, and suppliers abused the federal tax system with little consequence, an analysis from the Government Accounting Office found. More than 21,000 Medicare Part B providers—about 5% of the total—had tax debts totaling more than $1 billion, mainly individual income and payroll taxes. Sen. Norm Coleman (R-Minn.), ranking member of the Permanent Subcommittee on Investigations, is using the report to press the Centers for Medicare and Medicaid Services to adopt the federal levy system, which would allow the Internal Revenue Service and the Treasury Department to tap into Medicare payments to providers in order to cover back taxes. “This is a classic case of the right hand not knowing what the left hand is doing,” Sen. Coleman said in a statement, noting that the federal government could have collected between $50 million and $140 million in 2005 if CMS had participated in the levy program. Medicare officials said at a hearing in March that they are working with the IRS and other agencies to manage payment policies.

Penalized by High-Deductible Plans

High-deductible health insurance plans discriminate against women by leaving them with far higher out-of-pocket health bills than men, according to a study from Harvard Medical School, Boston. The study also found that adults aged 45–64 years, those with any chronic condition such as asthma or high blood pressure, and children taking even one medication were likely to suffer financially in high-deductible plans. Under the plans, patients must pay at least $1,050 before their health coverage kicks in. In 2006, the median cost of care (both insurance and out-of-pocket) for women aged 18–64 was $1,844, compared with $847 for men. For middle-aged adults, the mean expenditure was $1,849 for men and $2,871 for women. High blood pressure patients had a mean annual expenditure of $3,161, while diabetics taking at least one medication had a mean expenditure of $5,774. “Even common, mild problems like arthritis and high blood pressure make you a loser in a high deductible plan,” said Dr. David Himmelstein, study coauthor and an advocate of a single-payer system.

Retail Clinics Replacing PCPs

More than 1 in 10 retail medical clinic users said the clinics have mostly or completely replaced their primary care physicians for the types of treatments offered at such facilities, according to a study from Market Strategies Inc., a research firm. “Consumers are telling us in no uncertain terms that convenience is so critical to them that they will forego traditional primary care providers in exchange for access to the kind of quick and convenient basic care services offered by retail clinics,” said John Thomas, MSI vice president, in a statement. The MSI study also indicated that consumers who have used retail clinics are open to treatment for a wider range of conditions including migraine, dyslipidemia, and hypertension. In addition, 30% of all consumers polled said that the clinics should compete with primary care physicians by offering a broader variety of services. The American Academy of Family Physicians said in a February policy statement that retail clinics should have a “well-defined and limited scope of clinical services,” and that they should encourage all patients to have a medical home.

Negotiation Could Save $30 Billion

Legislation that would allow Medicare to use its bulk purchasing power to negotiate for lower prescription drug prices under Part D could save U.S. taxpayers and seniors more than $30 billion annually, an advocacy group reported. The Institute for American Research said that about $10 billion of those savings would accrue to U.S. seniors in the form of cheaper prices, while the U.S. government could save roughly $20 billion a year by having Medicare negotiate for the same prices the Department of Veterans Affairs already gets. However, the Pharmaceutical Research and Manufacturers of America (PhRMA), which represents drug makers and opposes the legislation, said that pharmacy benefit managers already are negotiating with manufacturers for lower prices under Part D.

Cuts Would Harm Seniors

Three-fourths of physicians said they believe that seniors will be harmed if Congress cuts the Medicare Advantage program, and the vast majority of doctors said lawmakers should cut other programs or raise taxes rather than cut Medicare Advantage, according to the industry group America's Health Insurance Plans (AHIP). In addition, 35% of seniors enrolled in Medicare Advantage said they would skip some of the health care treatments they currently receive if the option of choosing a Medicare health plan is taken away. The findings are from two surveys released by AHIP in March.

Changing MD Demographics

A major demographic shift is underway in medicine as female physicians become more numerous, and this trend will influence the way medical groups recruit and retain physicians throughout their career cycles, according to the 2006 Retention Survey from the American Medical Group Association and Cejka Search, an executive search organization. In 2006, female physicians accounted for 35% of physicians employed in the medical groups responding to the survey, compared with 28% in the previous survey. The study revealed that factors such as “poor cultural fit” and family issues are the driving forces in physician turnover. Part-time and flexible work options also are growing in importance, the survey found.

Docs Abuse Tax System

Thousands of Medicare Part B physicians, health professionals, and suppliers abused the federal tax system with little consequence, an analysis from the Government Accounting Office found. More than 21,000 Medicare Part B providers—about 5% of the total—had tax debts totaling more than $1 billion, mainly individual income and payroll taxes. Sen. Norm Coleman (R-Minn.), ranking member of the Permanent Subcommittee on Investigations, is using the report to press the Centers for Medicare and Medicaid Services to adopt the federal levy system, which would allow the Internal Revenue Service and the Treasury Department to tap into Medicare payments to providers in order to cover back taxes. “This is a classic case of the right hand not knowing what the left hand is doing,” Sen. Coleman said in a statement, noting that the federal government could have collected between $50 million and $140 million in 2005 if CMS had participated in the levy program. Medicare officials said at a hearing in March that they are working with the IRS and other agencies to manage payment policies.

Penalized by High-Deductible Plans

High-deductible health insurance plans discriminate against women by leaving them with far higher out-of-pocket health bills than men, according to a study from Harvard Medical School, Boston. The study also found that adults aged 45–64 years, those with any chronic condition such as asthma or high blood pressure, and children taking even one medication were likely to suffer financially in high-deductible plans. Under the plans, patients must pay at least $1,050 before their health coverage kicks in. In 2006, the median cost of care (both insurance and out-of-pocket) for women aged 18–64 was $1,844, compared with $847 for men. For middle-aged adults, the mean expenditure was $1,849 for men and $2,871 for women. High blood pressure patients had a mean annual expenditure of $3,161, while diabetics taking at least one medication had a mean expenditure of $5,774. “Even common, mild problems like arthritis and high blood pressure make you a loser in a high deductible plan,” said Dr. David Himmelstein, study coauthor and an advocate of a single-payer system.

Retail Clinics Replacing PCPs

More than 1 in 10 retail medical clinic users said the clinics have mostly or completely replaced their primary care physicians for the types of treatments offered at such facilities, according to a study from Market Strategies Inc., a research firm. “Consumers are telling us in no uncertain terms that convenience is so critical to them that they will forego traditional primary care providers in exchange for access to the kind of quick and convenient basic care services offered by retail clinics,” said John Thomas, MSI vice president, in a statement. The MSI study also indicated that consumers who have used retail clinics are open to treatment for a wider range of conditions including migraine, dyslipidemia, and hypertension. In addition, 30% of all consumers polled said that the clinics should compete with primary care physicians by offering a broader variety of services. The American Academy of Family Physicians said in a February policy statement that retail clinics should have a “well-defined and limited scope of clinical services,” and that they should encourage all patients to have a medical home.

Negotiation Could Save $30 Billion

Legislation that would allow Medicare to use its bulk purchasing power to negotiate for lower prescription drug prices under Part D could save U.S. taxpayers and seniors more than $30 billion annually, an advocacy group reported. The Institute for American Research said that about $10 billion of those savings would accrue to U.S. seniors in the form of cheaper prices, while the U.S. government could save roughly $20 billion a year by having Medicare negotiate for the same prices the Department of Veterans Affairs already gets. However, the Pharmaceutical Research and Manufacturers of America (PhRMA), which represents drug makers and opposes the legislation, said that pharmacy benefit managers already are negotiating with manufacturers for lower prices under Part D.

Cuts Would Harm Seniors

Three-fourths of physicians said they believe that seniors will be harmed if Congress cuts the Medicare Advantage program, and the vast majority of doctors said lawmakers should cut other programs or raise taxes rather than cut Medicare Advantage, according to the industry group America's Health Insurance Plans (AHIP). In addition, 35% of seniors enrolled in Medicare Advantage said they would skip some of the health care treatments they currently receive if the option of choosing a Medicare health plan is taken away. The findings are from two surveys released by AHIP in March.

Changing MD Demographics

A major demographic shift is underway in medicine as female physicians become more numerous, and this trend will influence the way medical groups recruit and retain physicians throughout their career cycles, according to the 2006 Retention Survey from the American Medical Group Association and Cejka Search, an executive search organization. In 2006, female physicians accounted for 35% of physicians employed in the medical groups responding to the survey, compared with 28% in the previous survey. The study revealed that factors such as “poor cultural fit” and family issues are the driving forces in physician turnover. Part-time and flexible work options also are growing in importance, the survey found.

First-year enrollment in U.S. medical schools is projected to increase 17% over the next 5 years to nearly 19,300 students, helping to ameliorate the real need for new physicians, according to an annual survey of medical-school expansion plans released by the Association of American Medical Colleges.

The estimated expansion would move U.S. medical schools to the halfway point of a 30% enrollment increase recommended by the AAMC in 2006.

However, a top official at the American Academy of Family Physicians said that although adding medical school slots is laudable, the real emphasis needs to be placed on creating more primary care physicians.

"We certainly agree that the aging population and expansion of the nation is going to result in an expanding need for health care services," said Dr. Perry Pugno, director of the division of medical education for AAFP.

"But it's not just a need for more doctors," he said. "We need more primary care physicians, especially family medicine doctors, to bring efficiency, cost-effectiveness, and better outcomes to the system."

The survey of 121 out of 125 U.S. medical-school deans took place last fall, and the information gathered was compared with that of the baseline academic year of 2002–2003, when first-year enrollment totaled 16,488 students. Survey results indicated that total first-year enrollment in existing U.S. medical schools is projected to increase by 2,558 students (15.5%) by 2012. Three-quarters of existing medical schools anticipate an increase, compared with 2002 enrollment levels.

However, the report notes that many of these planned increases depend upon state support or other outside funding sources. Projected enrollment for new medical schools accounts for an additional 1.5% percent of the total 17% expansion.

According to the survey, existing U.S. medical schools that are expanding will do so through a variety of mechanisms, including new clinical affiliations, expansion of existing campuses, and new regional or branch campuses.

Respondents also listed several barriers to enrollment increases, including the cost of such expansion, limited scholarship availability, tight classroom space, and too few ambulatory preceptors. A smaller number of schools reported a lack of basic science faculty, low numbers or variety of patients, problems with regulatory or accreditation requirements, and poor quality applicants as major barriers.

ELSEVIER GLOBAL MEDICAL NEWS

First-year enrollment in U.S. medical schools is projected to increase 17% over the next 5 years to nearly 19,300 students, helping to ameliorate the real need for new physicians, according to an annual survey of medical-school expansion plans released by the Association of American Medical Colleges.

The estimated expansion would move U.S. medical schools to the halfway point of a 30% enrollment increase recommended by the AAMC in 2006.

However, a top official at the American Academy of Family Physicians said that although adding medical school slots is laudable, the real emphasis needs to be placed on creating more primary care physicians.

"We certainly agree that the aging population and expansion of the nation is going to result in an expanding need for health care services," said Dr. Perry Pugno, director of the division of medical education for AAFP.

"But it's not just a need for more doctors," he said. "We need more primary care physicians, especially family medicine doctors, to bring efficiency, cost-effectiveness, and better outcomes to the system."

The survey of 121 out of 125 U.S. medical-school deans took place last fall, and the information gathered was compared with that of the baseline academic year of 2002–2003, when first-year enrollment totaled 16,488 students. Survey results indicated that total first-year enrollment in existing U.S. medical schools is projected to increase by 2,558 students (15.5%) by 2012. Three-quarters of existing medical schools anticipate an increase, compared with 2002 enrollment levels.

However, the report notes that many of these planned increases depend upon state support or other outside funding sources. Projected enrollment for new medical schools accounts for an additional 1.5% percent of the total 17% expansion.

According to the survey, existing U.S. medical schools that are expanding will do so through a variety of mechanisms, including new clinical affiliations, expansion of existing campuses, and new regional or branch campuses.

Respondents also listed several barriers to enrollment increases, including the cost of such expansion, limited scholarship availability, tight classroom space, and too few ambulatory preceptors. A smaller number of schools reported a lack of basic science faculty, low numbers or variety of patients, problems with regulatory or accreditation requirements, and poor quality applicants as major barriers.

ELSEVIER GLOBAL MEDICAL NEWS

First-year enrollment in U.S. medical schools is projected to increase 17% over the next 5 years to nearly 19,300 students, helping to ameliorate the real need for new physicians, according to an annual survey of medical-school expansion plans released by the Association of American Medical Colleges.

The estimated expansion would move U.S. medical schools to the halfway point of a 30% enrollment increase recommended by the AAMC in 2006.

However, a top official at the American Academy of Family Physicians said that although adding medical school slots is laudable, the real emphasis needs to be placed on creating more primary care physicians.

"We certainly agree that the aging population and expansion of the nation is going to result in an expanding need for health care services," said Dr. Perry Pugno, director of the division of medical education for AAFP.

"But it's not just a need for more doctors," he said. "We need more primary care physicians, especially family medicine doctors, to bring efficiency, cost-effectiveness, and better outcomes to the system."

The survey of 121 out of 125 U.S. medical-school deans took place last fall, and the information gathered was compared with that of the baseline academic year of 2002–2003, when first-year enrollment totaled 16,488 students. Survey results indicated that total first-year enrollment in existing U.S. medical schools is projected to increase by 2,558 students (15.5%) by 2012. Three-quarters of existing medical schools anticipate an increase, compared with 2002 enrollment levels.

However, the report notes that many of these planned increases depend upon state support or other outside funding sources. Projected enrollment for new medical schools accounts for an additional 1.5% percent of the total 17% expansion.

According to the survey, existing U.S. medical schools that are expanding will do so through a variety of mechanisms, including new clinical affiliations, expansion of existing campuses, and new regional or branch campuses.

Respondents also listed several barriers to enrollment increases, including the cost of such expansion, limited scholarship availability, tight classroom space, and too few ambulatory preceptors. A smaller number of schools reported a lack of basic science faculty, low numbers or variety of patients, problems with regulatory or accreditation requirements, and poor quality applicants as major barriers.

ELSEVIER GLOBAL MEDICAL NEWS

Ex-FDA Chief Fined

Former Food and Drug Administration Commissioner Lester Crawford, D.V.M., Ph.D., has been sentenced to 3 years of supervised probation and fines of slightly less than $90,000 for charges stemming from his ownership of stock in companies regulated by the FDA. The penalty exceeded a $50,000 fine in a plea agreement Dr. Crawford and federal prosecutors struck last year but still spared the former FDA chief jail time. U.S. Magistrate Judge Deborah Robinson of the District Court for the District of Columbia also ordered Dr. Crawford to perform 50 hours of community service. Dr. Crawford resigned his FDA administrator post in September 2005 after just 2 months and did not give a reason for his resignation. In October 2006, he pleaded guilty to charges of having a conflict of interest and false reporting of information about stocks that he and his wife owned. Prosecutors said that Dr. Crawford filed seven incorrect financial reports with a government ethics office and Congress beginning in 2002.

Insurance Cost Sharing

Fewer than 24% of private sector employees covered by employer-sponsored health insurance do not pay a portion of their own premium, down from 35% in 1998, according to a report from the Agency for Healthcare Research and Quality. In both years, employers were more likely to offer no-contribution single coverage than no-contribution family coverage; 18% of employees eligible for health insurance from their employer in 1998 worked in a firm that offered at least one family coverage plan that required no employee contribution, but by 2004, that rate had fallen to 13%, the report said.

Majority Want Access Guarantee

Nearly two-thirds of Americans believe the federal government should guarantee access to health care, and 60% are willing to pay more in taxes for that guarantee, according to a poll released last month by the New York Times and CBS News. Half of those polled said they would be willing to pay as much as $500 a year in additional taxes, while nearly 8 in 10 said they thought it was more important to provide universal access to health insurance than to extend the Bush administration's tax cuts. In addition, a quarter of those with insurance said that they or someone in their household had gone without a medical test or treatment because insurance would not cover it; 60% of those without insurance reported the same situation. The nationwide telephone poll of 1,281 adults was conducted in late February 2007.

Hospital Demonstration Extended

The Centers for Medicare and Medicaid Services has approved a 3-year extension of the Premier Hospital Quality Incentive Demonstration (HQID), a value-based purchasing project involving more than 260 hospitals across the country. Recently released second-year results of the demonstration show “substantial improvement” in quality of care across five clinical focus areas, including acute myocardial infarction, heart failure, coronary artery bypass graft, pneumonia, and hip and knee replacement, with total gains in quality over the first 2 years of 11.8 percentage points, CMS said in a statement. The hospitals involved have received incentive payments for providing high-quality care. During the first 3 years of the project, only top-performing hospitals have been eligible for incentive payments, but the 3-year extension will test the effectiveness of offering incentive payments to hospitals achieving a defined level of quality (or quality threshold) or achieving the greatest improvement in quality and a quality threshold.

Medicaid Growth Sustainable

Expected growth in government revenues is likely to be large enough to sustain Medicaid spending increases over the next 40 years while still allowing substantial real growth in spending for other public services, according to a study published in the Feb. 23 edition of the journal Health Affairs. The analysis by the Kaiser Family Foundation's Commission on Medicaid and the Uninsured looked at both potential long-term Medicaid spending and the availability of government revenues to support it. “While a substantial component of state government spending, Medicaid is not likely to be the financial burden squeezing out other public priorities that some policy makers fear,” said study coauthor Richard Kronick of the University of California, San Diego, in a statement. After accounting for demographic and health coverage trends such as an aging population and declines in employer-sponsored insurance, the study found that Medicaid's share (17% in 2005) of national health expenditures is expected to remain about the same until 2025 and then rise slowly to 19% by 2045. “Efforts to reduce the growth in Medicaid by shifting costs or threatening coverage will ultimately require better controlling the rate of growth of health spending overall,” Diane Rowland, executive director of KFF's commission said in a statement.

Hospitals Embrace IT

Nearly half of all community hospitals reported moderate or high use of health information technology (IT) in 2006, compared with 37% in 2005, according to recent survey results from the American Hospital Association. Hospitals also reported dramatic increases in the use of computerized alerts to prevent negative drug interactions; in 2006, 51% of hospitals were using real-time drug interaction alerts, up from 23% in 2005. Larger hospitals were more likely than smaller hospitals were to have heavy use of health IT, AHA said.

Ex-FDA Chief Fined

Former Food and Drug Administration Commissioner Lester Crawford, D.V.M., Ph.D., has been sentenced to 3 years of supervised probation and fines of slightly less than $90,000 for charges stemming from his ownership of stock in companies regulated by the FDA. The penalty exceeded a $50,000 fine in a plea agreement Dr. Crawford and federal prosecutors struck last year but still spared the former FDA chief jail time. U.S. Magistrate Judge Deborah Robinson of the District Court for the District of Columbia also ordered Dr. Crawford to perform 50 hours of community service. Dr. Crawford resigned his FDA administrator post in September 2005 after just 2 months and did not give a reason for his resignation. In October 2006, he pleaded guilty to charges of having a conflict of interest and false reporting of information about stocks that he and his wife owned. Prosecutors said that Dr. Crawford filed seven incorrect financial reports with a government ethics office and Congress beginning in 2002.

Insurance Cost Sharing

Fewer than 24% of private sector employees covered by employer-sponsored health insurance do not pay a portion of their own premium, down from 35% in 1998, according to a report from the Agency for Healthcare Research and Quality. In both years, employers were more likely to offer no-contribution single coverage than no-contribution family coverage; 18% of employees eligible for health insurance from their employer in 1998 worked in a firm that offered at least one family coverage plan that required no employee contribution, but by 2004, that rate had fallen to 13%, the report said.

Majority Want Access Guarantee

Nearly two-thirds of Americans believe the federal government should guarantee access to health care, and 60% are willing to pay more in taxes for that guarantee, according to a poll released last month by the New York Times and CBS News. Half of those polled said they would be willing to pay as much as $500 a year in additional taxes, while nearly 8 in 10 said they thought it was more important to provide universal access to health insurance than to extend the Bush administration's tax cuts. In addition, a quarter of those with insurance said that they or someone in their household had gone without a medical test or treatment because insurance would not cover it; 60% of those without insurance reported the same situation. The nationwide telephone poll of 1,281 adults was conducted in late February 2007.

Hospital Demonstration Extended

The Centers for Medicare and Medicaid Services has approved a 3-year extension of the Premier Hospital Quality Incentive Demonstration (HQID), a value-based purchasing project involving more than 260 hospitals across the country. Recently released second-year results of the demonstration show “substantial improvement” in quality of care across five clinical focus areas, including acute myocardial infarction, heart failure, coronary artery bypass graft, pneumonia, and hip and knee replacement, with total gains in quality over the first 2 years of 11.8 percentage points, CMS said in a statement. The hospitals involved have received incentive payments for providing high-quality care. During the first 3 years of the project, only top-performing hospitals have been eligible for incentive payments, but the 3-year extension will test the effectiveness of offering incentive payments to hospitals achieving a defined level of quality (or quality threshold) or achieving the greatest improvement in quality and a quality threshold.

Medicaid Growth Sustainable

Expected growth in government revenues is likely to be large enough to sustain Medicaid spending increases over the next 40 years while still allowing substantial real growth in spending for other public services, according to a study published in the Feb. 23 edition of the journal Health Affairs. The analysis by the Kaiser Family Foundation's Commission on Medicaid and the Uninsured looked at both potential long-term Medicaid spending and the availability of government revenues to support it. “While a substantial component of state government spending, Medicaid is not likely to be the financial burden squeezing out other public priorities that some policy makers fear,” said study coauthor Richard Kronick of the University of California, San Diego, in a statement. After accounting for demographic and health coverage trends such as an aging population and declines in employer-sponsored insurance, the study found that Medicaid's share (17% in 2005) of national health expenditures is expected to remain about the same until 2025 and then rise slowly to 19% by 2045. “Efforts to reduce the growth in Medicaid by shifting costs or threatening coverage will ultimately require better controlling the rate of growth of health spending overall,” Diane Rowland, executive director of KFF's commission said in a statement.

Hospitals Embrace IT

Nearly half of all community hospitals reported moderate or high use of health information technology (IT) in 2006, compared with 37% in 2005, according to recent survey results from the American Hospital Association. Hospitals also reported dramatic increases in the use of computerized alerts to prevent negative drug interactions; in 2006, 51% of hospitals were using real-time drug interaction alerts, up from 23% in 2005. Larger hospitals were more likely than smaller hospitals were to have heavy use of health IT, AHA said.

Ex-FDA Chief Fined

Former Food and Drug Administration Commissioner Lester Crawford, D.V.M., Ph.D., has been sentenced to 3 years of supervised probation and fines of slightly less than $90,000 for charges stemming from his ownership of stock in companies regulated by the FDA. The penalty exceeded a $50,000 fine in a plea agreement Dr. Crawford and federal prosecutors struck last year but still spared the former FDA chief jail time. U.S. Magistrate Judge Deborah Robinson of the District Court for the District of Columbia also ordered Dr. Crawford to perform 50 hours of community service. Dr. Crawford resigned his FDA administrator post in September 2005 after just 2 months and did not give a reason for his resignation. In October 2006, he pleaded guilty to charges of having a conflict of interest and false reporting of information about stocks that he and his wife owned. Prosecutors said that Dr. Crawford filed seven incorrect financial reports with a government ethics office and Congress beginning in 2002.

Insurance Cost Sharing

Fewer than 24% of private sector employees covered by employer-sponsored health insurance do not pay a portion of their own premium, down from 35% in 1998, according to a report from the Agency for Healthcare Research and Quality. In both years, employers were more likely to offer no-contribution single coverage than no-contribution family coverage; 18% of employees eligible for health insurance from their employer in 1998 worked in a firm that offered at least one family coverage plan that required no employee contribution, but by 2004, that rate had fallen to 13%, the report said.

Majority Want Access Guarantee

Nearly two-thirds of Americans believe the federal government should guarantee access to health care, and 60% are willing to pay more in taxes for that guarantee, according to a poll released last month by the New York Times and CBS News. Half of those polled said they would be willing to pay as much as $500 a year in additional taxes, while nearly 8 in 10 said they thought it was more important to provide universal access to health insurance than to extend the Bush administration's tax cuts. In addition, a quarter of those with insurance said that they or someone in their household had gone without a medical test or treatment because insurance would not cover it; 60% of those without insurance reported the same situation. The nationwide telephone poll of 1,281 adults was conducted in late February 2007.

Hospital Demonstration Extended

The Centers for Medicare and Medicaid Services has approved a 3-year extension of the Premier Hospital Quality Incentive Demonstration (HQID), a value-based purchasing project involving more than 260 hospitals across the country. Recently released second-year results of the demonstration show “substantial improvement” in quality of care across five clinical focus areas, including acute myocardial infarction, heart failure, coronary artery bypass graft, pneumonia, and hip and knee replacement, with total gains in quality over the first 2 years of 11.8 percentage points, CMS said in a statement. The hospitals involved have received incentive payments for providing high-quality care. During the first 3 years of the project, only top-performing hospitals have been eligible for incentive payments, but the 3-year extension will test the effectiveness of offering incentive payments to hospitals achieving a defined level of quality (or quality threshold) or achieving the greatest improvement in quality and a quality threshold.

Medicaid Growth Sustainable

Expected growth in government revenues is likely to be large enough to sustain Medicaid spending increases over the next 40 years while still allowing substantial real growth in spending for other public services, according to a study published in the Feb. 23 edition of the journal Health Affairs. The analysis by the Kaiser Family Foundation's Commission on Medicaid and the Uninsured looked at both potential long-term Medicaid spending and the availability of government revenues to support it. “While a substantial component of state government spending, Medicaid is not likely to be the financial burden squeezing out other public priorities that some policy makers fear,” said study coauthor Richard Kronick of the University of California, San Diego, in a statement. After accounting for demographic and health coverage trends such as an aging population and declines in employer-sponsored insurance, the study found that Medicaid's share (17% in 2005) of national health expenditures is expected to remain about the same until 2025 and then rise slowly to 19% by 2045. “Efforts to reduce the growth in Medicaid by shifting costs or threatening coverage will ultimately require better controlling the rate of growth of health spending overall,” Diane Rowland, executive director of KFF's commission said in a statement.

Hospitals Embrace IT

Nearly half of all community hospitals reported moderate or high use of health information technology (IT) in 2006, compared with 37% in 2005, according to recent survey results from the American Hospital Association. Hospitals also reported dramatic increases in the use of computerized alerts to prevent negative drug interactions; in 2006, 51% of hospitals were using real-time drug interaction alerts, up from 23% in 2005. Larger hospitals were more likely than smaller hospitals were to have heavy use of health IT, AHA said.

CMS Extends Claims Form Deadline

The Centers for Medicare and Medicaid Services has extended the deadline for filing Medicare claims using its new version of claims form CMS-1500, because of formatting errors on the revised form, CMS announced. The original deadline for switching to the new form, known as CMS-1500 (08–05) originally was April 2. But CMS said last month that contractors have been directed to continue to accept the old form until the agency notifies them to stop. In addition, the agency advised physicians who must use the form to use legacy provider numbers as the form cannot accommodate a National Provider Identification (NPI) number.

Oncologist Shortfall Predicted

The United States will have a shortage of 2,550–4,080 oncologists by 2020—roughly one-quarter to one-third of the 2005 supply—as the demand for services increases by 48%, according to a report by the American Society of Clinical Oncology. Meanwhile, the supply of services provided by oncologists is expected to grow by just 14% by 2020, leading to a shortage representing up to 15 million visits per year. Options to fill the shortfall include redesigning service delivery, increasing fellowship positions and the use of nonphysician clinicians, and having primary care physicians provide more care for patients in remission. The report on the final results of the ASCO Oncology Workforce Study based its conclusions on the current age distribution and practice patterns of oncologists and the number of oncology fellowship positions.

Prescription Drug Sales Up

U.S. prescription drug sales grew more than 8% to $275 billion in 2006, fueled by the Medicare Part D prescription benefit, increased utilization of generics within new therapy classes, and new drug launches, said pharmaceutical data firm IMS Health. Total dispensed prescriptions grew at nearly a 5% pace, compared with slightly more than 3% in 2005, the firm said. Part D was a large driver of the upward trend, lifting prescription volume by an estimated 1–2 percentage points and pharmaceutical sales by about 1 percentage point. The benefit “increased prescription coverage to the previously uninsured and underinsured, and provided generous plan benefits to seniors,” said Diana Conmy, corporate director, IMS Market Insights, in a statement. Meanwhile, drug makers released new generic forms of lipid regulators, antidepressants and inhaled steroids, resulting in significant growth for those classes of medications. Sales of prescription drugs in the United States are expected to decline in 2007, IMS Health said.

Veterans Bill Introduced

Veterans with service-connected disabilities would be able to go to the hospital or medical clinic of their choice under legislation introduced by Sen. Larry Craig (R-Idaho). The senator said he was concerned about the care lapses documented at Walter Reed Hospital in Washington, but said that he was willing to pit the health care system run by the U.S. Department of Veterans Affairs against private sector providers because he considered the VA system among the best in the nation. “This bill is about my confidence in the VA,” Sen. Craig said in a statement. “Let's see where veterans choose to go. It's very simple: If service-connected veterans leave in droves, we've learned something. But, if veterans overwhelmingly stay, and I think they will, we've also learned something.”

Medical Debt Increasing

Families are turning to credit cards to pay for medical care as health care costs continue to rise faster than incomes, according to new research by public policy advocacy groups Demos and the Access Project. The groups found that 29% of low- and middle-income households with credit card debt reported that medical expenses contributed to their current balances, and within that group, 69% had a major medical expense in the previous 3 years. Low- and middle-income medically indebted households had, on average, 46% higher levels of credit card debt than those without medical debt. In addition, the medically indebted were almost twice as likely to be called by bill collectors than were the nonmedically indebted. “Congress should address this new and serious consequence of our nation's growing health care crisis before more families go into debt, and risk their financial stability, to get the medical care they need,” report coauthor Cindy Zeldin of Demos said in a statement.

Drug Executives Admit Fraud

Four executives from the bankrupt generic drug maker Able Laboratories Inc., pleaded guilty in March to roles in a 7-year scheme to falsify data at the company, which had made 46 generic versions of brand-name, mostly prescription drugs for pain, inflammation, obesity, and cardiovascular conditions. The highest ranking official of the four, Shashikant Shah, vice president for quality control and regulatory affairs, also pleaded guilty to a securities fraud charge. The Food and Drug Administration has said that the company, based in Cranbury, N.J., invented data so its drugs would appear to meet federal standards when in fact they had too much or too little of their active ingredients. This occurred 41 times dating back to 2001, while on nine other occasions, Able failed to issue alerts about impure drugs. Able, which recalled all of its prescription products in May 2005 as part of an agreement with the FDA, filed for bankruptcy protection in July 2005 and liquidated its assets in March 2006.

CMS Extends Claims Form Deadline

The Centers for Medicare and Medicaid Services has extended the deadline for filing Medicare claims using its new version of claims form CMS-1500, because of formatting errors on the revised form, CMS announced. The original deadline for switching to the new form, known as CMS-1500 (08–05) originally was April 2. But CMS said last month that contractors have been directed to continue to accept the old form until the agency notifies them to stop. In addition, the agency advised physicians who must use the form to use legacy provider numbers as the form cannot accommodate a National Provider Identification (NPI) number.

Oncologist Shortfall Predicted

The United States will have a shortage of 2,550–4,080 oncologists by 2020—roughly one-quarter to one-third of the 2005 supply—as the demand for services increases by 48%, according to a report by the American Society of Clinical Oncology. Meanwhile, the supply of services provided by oncologists is expected to grow by just 14% by 2020, leading to a shortage representing up to 15 million visits per year. Options to fill the shortfall include redesigning service delivery, increasing fellowship positions and the use of nonphysician clinicians, and having primary care physicians provide more care for patients in remission. The report on the final results of the ASCO Oncology Workforce Study based its conclusions on the current age distribution and practice patterns of oncologists and the number of oncology fellowship positions.

Prescription Drug Sales Up

U.S. prescription drug sales grew more than 8% to $275 billion in 2006, fueled by the Medicare Part D prescription benefit, increased utilization of generics within new therapy classes, and new drug launches, said pharmaceutical data firm IMS Health. Total dispensed prescriptions grew at nearly a 5% pace, compared with slightly more than 3% in 2005, the firm said. Part D was a large driver of the upward trend, lifting prescription volume by an estimated 1–2 percentage points and pharmaceutical sales by about 1 percentage point. The benefit “increased prescription coverage to the previously uninsured and underinsured, and provided generous plan benefits to seniors,” said Diana Conmy, corporate director, IMS Market Insights, in a statement. Meanwhile, drug makers released new generic forms of lipid regulators, antidepressants and inhaled steroids, resulting in significant growth for those classes of medications. Sales of prescription drugs in the United States are expected to decline in 2007, IMS Health said.

Veterans Bill Introduced

Veterans with service-connected disabilities would be able to go to the hospital or medical clinic of their choice under legislation introduced by Sen. Larry Craig (R-Idaho). The senator said he was concerned about the care lapses documented at Walter Reed Hospital in Washington, but said that he was willing to pit the health care system run by the U.S. Department of Veterans Affairs against private sector providers because he considered the VA system among the best in the nation. “This bill is about my confidence in the VA,” Sen. Craig said in a statement. “Let's see where veterans choose to go. It's very simple: If service-connected veterans leave in droves, we've learned something. But, if veterans overwhelmingly stay, and I think they will, we've also learned something.”

Medical Debt Increasing

Families are turning to credit cards to pay for medical care as health care costs continue to rise faster than incomes, according to new research by public policy advocacy groups Demos and the Access Project. The groups found that 29% of low- and middle-income households with credit card debt reported that medical expenses contributed to their current balances, and within that group, 69% had a major medical expense in the previous 3 years. Low- and middle-income medically indebted households had, on average, 46% higher levels of credit card debt than those without medical debt. In addition, the medically indebted were almost twice as likely to be called by bill collectors than were the nonmedically indebted. “Congress should address this new and serious consequence of our nation's growing health care crisis before more families go into debt, and risk their financial stability, to get the medical care they need,” report coauthor Cindy Zeldin of Demos said in a statement.

Drug Executives Admit Fraud

Four executives from the bankrupt generic drug maker Able Laboratories Inc., pleaded guilty in March to roles in a 7-year scheme to falsify data at the company, which had made 46 generic versions of brand-name, mostly prescription drugs for pain, inflammation, obesity, and cardiovascular conditions. The highest ranking official of the four, Shashikant Shah, vice president for quality control and regulatory affairs, also pleaded guilty to a securities fraud charge. The Food and Drug Administration has said that the company, based in Cranbury, N.J., invented data so its drugs would appear to meet federal standards when in fact they had too much or too little of their active ingredients. This occurred 41 times dating back to 2001, while on nine other occasions, Able failed to issue alerts about impure drugs. Able, which recalled all of its prescription products in May 2005 as part of an agreement with the FDA, filed for bankruptcy protection in July 2005 and liquidated its assets in March 2006.

CMS Extends Claims Form Deadline

The Centers for Medicare and Medicaid Services has extended the deadline for filing Medicare claims using its new version of claims form CMS-1500, because of formatting errors on the revised form, CMS announced. The original deadline for switching to the new form, known as CMS-1500 (08–05) originally was April 2. But CMS said last month that contractors have been directed to continue to accept the old form until the agency notifies them to stop. In addition, the agency advised physicians who must use the form to use legacy provider numbers as the form cannot accommodate a National Provider Identification (NPI) number.

Oncologist Shortfall Predicted

The United States will have a shortage of 2,550–4,080 oncologists by 2020—roughly one-quarter to one-third of the 2005 supply—as the demand for services increases by 48%, according to a report by the American Society of Clinical Oncology. Meanwhile, the supply of services provided by oncologists is expected to grow by just 14% by 2020, leading to a shortage representing up to 15 million visits per year. Options to fill the shortfall include redesigning service delivery, increasing fellowship positions and the use of nonphysician clinicians, and having primary care physicians provide more care for patients in remission. The report on the final results of the ASCO Oncology Workforce Study based its conclusions on the current age distribution and practice patterns of oncologists and the number of oncology fellowship positions.

Prescription Drug Sales Up

U.S. prescription drug sales grew more than 8% to $275 billion in 2006, fueled by the Medicare Part D prescription benefit, increased utilization of generics within new therapy classes, and new drug launches, said pharmaceutical data firm IMS Health. Total dispensed prescriptions grew at nearly a 5% pace, compared with slightly more than 3% in 2005, the firm said. Part D was a large driver of the upward trend, lifting prescription volume by an estimated 1–2 percentage points and pharmaceutical sales by about 1 percentage point. The benefit “increased prescription coverage to the previously uninsured and underinsured, and provided generous plan benefits to seniors,” said Diana Conmy, corporate director, IMS Market Insights, in a statement. Meanwhile, drug makers released new generic forms of lipid regulators, antidepressants and inhaled steroids, resulting in significant growth for those classes of medications. Sales of prescription drugs in the United States are expected to decline in 2007, IMS Health said.

Veterans Bill Introduced

Veterans with service-connected disabilities would be able to go to the hospital or medical clinic of their choice under legislation introduced by Sen. Larry Craig (R-Idaho). The senator said he was concerned about the care lapses documented at Walter Reed Hospital in Washington, but said that he was willing to pit the health care system run by the U.S. Department of Veterans Affairs against private sector providers because he considered the VA system among the best in the nation. “This bill is about my confidence in the VA,” Sen. Craig said in a statement. “Let's see where veterans choose to go. It's very simple: If service-connected veterans leave in droves, we've learned something. But, if veterans overwhelmingly stay, and I think they will, we've also learned something.”

Medical Debt Increasing

Families are turning to credit cards to pay for medical care as health care costs continue to rise faster than incomes, according to new research by public policy advocacy groups Demos and the Access Project. The groups found that 29% of low- and middle-income households with credit card debt reported that medical expenses contributed to their current balances, and within that group, 69% had a major medical expense in the previous 3 years. Low- and middle-income medically indebted households had, on average, 46% higher levels of credit card debt than those without medical debt. In addition, the medically indebted were almost twice as likely to be called by bill collectors than were the nonmedically indebted. “Congress should address this new and serious consequence of our nation's growing health care crisis before more families go into debt, and risk their financial stability, to get the medical care they need,” report coauthor Cindy Zeldin of Demos said in a statement.

Drug Executives Admit Fraud

Four executives from the bankrupt generic drug maker Able Laboratories Inc., pleaded guilty in March to roles in a 7-year scheme to falsify data at the company, which had made 46 generic versions of brand-name, mostly prescription drugs for pain, inflammation, obesity, and cardiovascular conditions. The highest ranking official of the four, Shashikant Shah, vice president for quality control and regulatory affairs, also pleaded guilty to a securities fraud charge. The Food and Drug Administration has said that the company, based in Cranbury, N.J., invented data so its drugs would appear to meet federal standards when in fact they had too much or too little of their active ingredients. This occurred 41 times dating back to 2001, while on nine other occasions, Able failed to issue alerts about impure drugs. Able, which recalled all of its prescription products in May 2005 as part of an agreement with the FDA, filed for bankruptcy protection in July 2005 and liquidated its assets in March 2006.

American consumers and their employers are treading cautiously when it comes to switching from traditional, more comprehensive health insurance to consumer-driven health plans, with few actually adopting the new plans, according to recent survey results from the Employee Benefit Research Institute (EBRI) and the Commonwealth Fund.

In addition, satisfaction among members in consumer-driven health plans (CDHPs) was considerably lower than satisfaction among individuals in more traditional plans, and more members in CDHPs reported that they had delayed getting needed medical care.

The Consumerism in Health Care Survey tracks public opinion on consumer-driven and high-deductible plans, defined as those plans with deductibles of $1,000 or more for employee-only coverage and $2,000 or more for family coverage. The plans also feature one of two kinds of tax-exempt savings accounts: health savings accounts (HSAs) and health reimbursement arrangements (HRAs). Employees can use money in the accounts without tax penalty to pay for medical expenses not covered by their health plans.

“Consumer-driven health plans aim to control costs largely through demand-side incentives, and to make premiums more affordable for the uninsured,” said Karen Davis, Ph.D., president of the Commonwealth Fund, at a press teleconference sponsored by the fund and EBRI.

But the survey found that the plans have been slow to catch on. Just 1% of the privately insured U.S. population aged 21–64 years, or 1.3 million individuals, were enrolled in CDHPs in September 2006, unchanged from the year before—despite the widespread attention the new plans have received. Another 7% (8.5 million adults), had plans with deductibles high enough to qualify for health savings accounts but did not have an account.

Employers are cautiously awaiting data on the cost and effectiveness of the plans before switching coverage to CDHPs, Dr. Davis said.

“The plans are not well known at this point,” said Paul Fronstin, EBRI senior research associate. “Only 7% of the population responded that they are 'very familiar' with consumer-directed health plans, while 13% said they were 'somewhat familiar.'”

In addition, despite the expectations of some policy makers that the lower premiums and tax benefits of CDHPs would substantially reduce the number of people without health insurance, “we did find that individuals in consumer-directed plans were not more likely to have been uninsured than those enrolled in a conventional plan,” said Mr. Fronstin.

Satisfaction lags in the plans, compared with more comprehensive health insurance, the survey found. And, 38% of those with consumer-driven coverage said that they delayed or avoided getting needed health care because of cost over the last 12 months, compared with 19% of those with comprehensive insurance.

It's no surprise that employers and employees have been cautious in adopting CDHPs, since effecting change in the health insurance industry can be very difficult, said Karen Atwood, senior vice president for national accounts at Blue Cross and Blue Shield of Illinois.

“We are in the early stages of trying to understand how consumerism can be part of the solution,” said Atwood, who added that such plans also need to have tools in place to address lifestyle behaviors and choices. “We need good plans, well-crafted network options, and incentives to reward people for doing the right thing.”

The study of 3,158 U.S. adults aged 21–64 was conducted through a 14-minute Internet survey.

American consumers and their employers are treading cautiously when it comes to switching from traditional, more comprehensive health insurance to consumer-driven health plans, with few actually adopting the new plans, according to recent survey results from the Employee Benefit Research Institute (EBRI) and the Commonwealth Fund.

In addition, satisfaction among members in consumer-driven health plans (CDHPs) was considerably lower than satisfaction among individuals in more traditional plans, and more members in CDHPs reported that they had delayed getting needed medical care.

The Consumerism in Health Care Survey tracks public opinion on consumer-driven and high-deductible plans, defined as those plans with deductibles of $1,000 or more for employee-only coverage and $2,000 or more for family coverage. The plans also feature one of two kinds of tax-exempt savings accounts: health savings accounts (HSAs) and health reimbursement arrangements (HRAs). Employees can use money in the accounts without tax penalty to pay for medical expenses not covered by their health plans.

“Consumer-driven health plans aim to control costs largely through demand-side incentives, and to make premiums more affordable for the uninsured,” said Karen Davis, Ph.D., president of the Commonwealth Fund, at a press teleconference sponsored by the fund and EBRI.

But the survey found that the plans have been slow to catch on. Just 1% of the privately insured U.S. population aged 21–64 years, or 1.3 million individuals, were enrolled in CDHPs in September 2006, unchanged from the year before—despite the widespread attention the new plans have received. Another 7% (8.5 million adults), had plans with deductibles high enough to qualify for health savings accounts but did not have an account.

Employers are cautiously awaiting data on the cost and effectiveness of the plans before switching coverage to CDHPs, Dr. Davis said.

“The plans are not well known at this point,” said Paul Fronstin, EBRI senior research associate. “Only 7% of the population responded that they are 'very familiar' with consumer-directed health plans, while 13% said they were 'somewhat familiar.'”

In addition, despite the expectations of some policy makers that the lower premiums and tax benefits of CDHPs would substantially reduce the number of people without health insurance, “we did find that individuals in consumer-directed plans were not more likely to have been uninsured than those enrolled in a conventional plan,” said Mr. Fronstin.

Satisfaction lags in the plans, compared with more comprehensive health insurance, the survey found. And, 38% of those with consumer-driven coverage said that they delayed or avoided getting needed health care because of cost over the last 12 months, compared with 19% of those with comprehensive insurance.

It's no surprise that employers and employees have been cautious in adopting CDHPs, since effecting change in the health insurance industry can be very difficult, said Karen Atwood, senior vice president for national accounts at Blue Cross and Blue Shield of Illinois.

“We are in the early stages of trying to understand how consumerism can be part of the solution,” said Atwood, who added that such plans also need to have tools in place to address lifestyle behaviors and choices. “We need good plans, well-crafted network options, and incentives to reward people for doing the right thing.”

The study of 3,158 U.S. adults aged 21–64 was conducted through a 14-minute Internet survey.

American consumers and their employers are treading cautiously when it comes to switching from traditional, more comprehensive health insurance to consumer-driven health plans, with few actually adopting the new plans, according to recent survey results from the Employee Benefit Research Institute (EBRI) and the Commonwealth Fund.

In addition, satisfaction among members in consumer-driven health plans (CDHPs) was considerably lower than satisfaction among individuals in more traditional plans, and more members in CDHPs reported that they had delayed getting needed medical care.

The Consumerism in Health Care Survey tracks public opinion on consumer-driven and high-deductible plans, defined as those plans with deductibles of $1,000 or more for employee-only coverage and $2,000 or more for family coverage. The plans also feature one of two kinds of tax-exempt savings accounts: health savings accounts (HSAs) and health reimbursement arrangements (HRAs). Employees can use money in the accounts without tax penalty to pay for medical expenses not covered by their health plans.

“Consumer-driven health plans aim to control costs largely through demand-side incentives, and to make premiums more affordable for the uninsured,” said Karen Davis, Ph.D., president of the Commonwealth Fund, at a press teleconference sponsored by the fund and EBRI.

But the survey found that the plans have been slow to catch on. Just 1% of the privately insured U.S. population aged 21–64 years, or 1.3 million individuals, were enrolled in CDHPs in September 2006, unchanged from the year before—despite the widespread attention the new plans have received. Another 7% (8.5 million adults), had plans with deductibles high enough to qualify for health savings accounts but did not have an account.

Employers are cautiously awaiting data on the cost and effectiveness of the plans before switching coverage to CDHPs, Dr. Davis said.

“The plans are not well known at this point,” said Paul Fronstin, EBRI senior research associate. “Only 7% of the population responded that they are 'very familiar' with consumer-directed health plans, while 13% said they were 'somewhat familiar.'”

In addition, despite the expectations of some policy makers that the lower premiums and tax benefits of CDHPs would substantially reduce the number of people without health insurance, “we did find that individuals in consumer-directed plans were not more likely to have been uninsured than those enrolled in a conventional plan,” said Mr. Fronstin.

Satisfaction lags in the plans, compared with more comprehensive health insurance, the survey found. And, 38% of those with consumer-driven coverage said that they delayed or avoided getting needed health care because of cost over the last 12 months, compared with 19% of those with comprehensive insurance.

It's no surprise that employers and employees have been cautious in adopting CDHPs, since effecting change in the health insurance industry can be very difficult, said Karen Atwood, senior vice president for national accounts at Blue Cross and Blue Shield of Illinois.

“We are in the early stages of trying to understand how consumerism can be part of the solution,” said Atwood, who added that such plans also need to have tools in place to address lifestyle behaviors and choices. “We need good plans, well-crafted network options, and incentives to reward people for doing the right thing.”

The study of 3,158 U.S. adults aged 21–64 was conducted through a 14-minute Internet survey.

Specialists across the country are demanding payment for being on call to the emergency department, and many hospitals are acceding in an effort to keep full coverage.

But even though more than one-third of hospitals now pay their on-call specialists, experts in emergency medicine say the on-call specialist crisis isn't one that can be solved by money. “Money talks, but only to a point,” said Dr. Todd B. Taylor, an emergency physician in Nashville, Tenn., and speaker of the American College of Emergency Physicians Council. “Money is not going to solve this problem because of the other issues involved. At some point, you bankrupt the system.”

For example, Dr. Taylor said he calculated that paying all on-call specialists “the going rate” ($1,000 a night and up) would cost hospitals in just the state of Arizona $176 million annually. “And that's assuming you could find people willing to do it at all. I've seen many specialists who say 'You can't pay me enough to do this.'” he said. “If you don't solve the liability issues surrounding being on call, at some point nothing else matters.”

The American Hospital Association found in survey data from 1 year ago that 38% of hospitals paid “for at least some coverage,” said Caroline Steinberg, AHA's vice president for trends analysis. “It seems to be a growing trend,” she commented.

And, in a study released in January online in the Annals of Emergency Medicine, researchers from Oregon Health & Science University (OHSU), Sutter Emergency Medical Associates, the University of Iowa, and the Office of Oregon Health Policy and Research reported that 43% of Oregon's 54 hospitals pay a stipend to at least one specialty, and 31% of hospitals guarantee pay for uninsured patients treated on call. Stipends ranged from $300 per month to more than $3,000 per night, with a median stipend of $1,000 per night to take call.

The statewide survey, conducted in the summer of 2005, showed coverage shortages in most specialties, with the most acute shortages in orthopedics and neurosurgery. More than half of all hospitals expressed difficulty in maintaining specialists on call for three or more specialties.

Orthopedists, neurosurgeons, and trauma surgeons were the specialists most likely to receive stipends, as reported in the survey. But survey author K. John McConnell, Ph.D., a researcher in emergency medicine at OHSU, noted that he also is beginning to hear about hand surgeons, obstetricians, otolaryngologists, and urologists asking to be paid to be on call.

Many specialists now have the opportunity to practice in a 9-to-5 setting, Dr. McConnell said, which makes them less willing to be on call. “There's no evil intent or bad guys—it's just everyone responding to changing dynamics,” he said.

Dr. Taylor agreed that lifestyle issues play a role in the shortage of on-call specialists and in their increasing demands to be paid for on-call duty. But he said that organizational and liability issues each play a bigger role. Hospitals and physicians must learn to arrange services and payment so that a specialist can be on call for 24 hours and then off the next day without losing income or hurting his or her own practice, Dr. Taylor said, adding that specialists “are starting to learn some lessons that emergency medicine learned years ago.”

The AHA has not taken a position on payment of specialists for being on call, but Ms. Steinberg said the group is sympathetic to physicians' problems. “We understand that physicians are being underpaid by Medicare and by private payers, and are facing huge professional liability,” she said.

Otolaryngologist Eric Furst of Springfield, Va., said that he and his ENT colleagues recently approached Inova Fairfax Hospital in an attempt to negotiate payment for being on call. Dr. Furst said that Inova Fairfax, the only level I trauma center in northern Virginia, requires its physicians to take call, and for his section, it amounts to a week at a time two times a year. Several ENT specialists have left because of the demands, he said, which increases the on-call burden for those who remain. “Before you know it, it is a huge financial hit in those weeks in your own practice,” he said.

After its 22 urologists threatened to stop responding to on-call care earlier this year, Inova Fairfax set up a fund to reimburse all 36 medical and surgical specialties that participate in emergency department on call for indigent care.

Specialists across the country are demanding payment for being on call to the emergency department, and many hospitals are acceding in an effort to keep full coverage.

But even though more than one-third of hospitals now pay their on-call specialists, experts in emergency medicine say the on-call specialist crisis isn't one that can be solved by money. “Money talks, but only to a point,” said Dr. Todd B. Taylor, an emergency physician in Nashville, Tenn., and speaker of the American College of Emergency Physicians Council. “Money is not going to solve this problem because of the other issues involved. At some point, you bankrupt the system.”

For example, Dr. Taylor said he calculated that paying all on-call specialists “the going rate” ($1,000 a night and up) would cost hospitals in just the state of Arizona $176 million annually. “And that's assuming you could find people willing to do it at all. I've seen many specialists who say 'You can't pay me enough to do this.'” he said. “If you don't solve the liability issues surrounding being on call, at some point nothing else matters.”

The American Hospital Association found in survey data from 1 year ago that 38% of hospitals paid “for at least some coverage,” said Caroline Steinberg, AHA's vice president for trends analysis. “It seems to be a growing trend,” she commented.

And, in a study released in January online in the Annals of Emergency Medicine, researchers from Oregon Health & Science University (OHSU), Sutter Emergency Medical Associates, the University of Iowa, and the Office of Oregon Health Policy and Research reported that 43% of Oregon's 54 hospitals pay a stipend to at least one specialty, and 31% of hospitals guarantee pay for uninsured patients treated on call. Stipends ranged from $300 per month to more than $3,000 per night, with a median stipend of $1,000 per night to take call.

The statewide survey, conducted in the summer of 2005, showed coverage shortages in most specialties, with the most acute shortages in orthopedics and neurosurgery. More than half of all hospitals expressed difficulty in maintaining specialists on call for three or more specialties.

Orthopedists, neurosurgeons, and trauma surgeons were the specialists most likely to receive stipends, as reported in the survey. But survey author K. John McConnell, Ph.D., a researcher in emergency medicine at OHSU, noted that he also is beginning to hear about hand surgeons, obstetricians, otolaryngologists, and urologists asking to be paid to be on call.

Many specialists now have the opportunity to practice in a 9-to-5 setting, Dr. McConnell said, which makes them less willing to be on call. “There's no evil intent or bad guys—it's just everyone responding to changing dynamics,” he said.

Dr. Taylor agreed that lifestyle issues play a role in the shortage of on-call specialists and in their increasing demands to be paid for on-call duty. But he said that organizational and liability issues each play a bigger role. Hospitals and physicians must learn to arrange services and payment so that a specialist can be on call for 24 hours and then off the next day without losing income or hurting his or her own practice, Dr. Taylor said, adding that specialists “are starting to learn some lessons that emergency medicine learned years ago.”

The AHA has not taken a position on payment of specialists for being on call, but Ms. Steinberg said the group is sympathetic to physicians' problems. “We understand that physicians are being underpaid by Medicare and by private payers, and are facing huge professional liability,” she said.

Otolaryngologist Eric Furst of Springfield, Va., said that he and his ENT colleagues recently approached Inova Fairfax Hospital in an attempt to negotiate payment for being on call. Dr. Furst said that Inova Fairfax, the only level I trauma center in northern Virginia, requires its physicians to take call, and for his section, it amounts to a week at a time two times a year. Several ENT specialists have left because of the demands, he said, which increases the on-call burden for those who remain. “Before you know it, it is a huge financial hit in those weeks in your own practice,” he said.

After its 22 urologists threatened to stop responding to on-call care earlier this year, Inova Fairfax set up a fund to reimburse all 36 medical and surgical specialties that participate in emergency department on call for indigent care.

Specialists across the country are demanding payment for being on call to the emergency department, and many hospitals are acceding in an effort to keep full coverage.

But even though more than one-third of hospitals now pay their on-call specialists, experts in emergency medicine say the on-call specialist crisis isn't one that can be solved by money. “Money talks, but only to a point,” said Dr. Todd B. Taylor, an emergency physician in Nashville, Tenn., and speaker of the American College of Emergency Physicians Council. “Money is not going to solve this problem because of the other issues involved. At some point, you bankrupt the system.”

For example, Dr. Taylor said he calculated that paying all on-call specialists “the going rate” ($1,000 a night and up) would cost hospitals in just the state of Arizona $176 million annually. “And that's assuming you could find people willing to do it at all. I've seen many specialists who say 'You can't pay me enough to do this.'” he said. “If you don't solve the liability issues surrounding being on call, at some point nothing else matters.”

The American Hospital Association found in survey data from 1 year ago that 38% of hospitals paid “for at least some coverage,” said Caroline Steinberg, AHA's vice president for trends analysis. “It seems to be a growing trend,” she commented.

And, in a study released in January online in the Annals of Emergency Medicine, researchers from Oregon Health & Science University (OHSU), Sutter Emergency Medical Associates, the University of Iowa, and the Office of Oregon Health Policy and Research reported that 43% of Oregon's 54 hospitals pay a stipend to at least one specialty, and 31% of hospitals guarantee pay for uninsured patients treated on call. Stipends ranged from $300 per month to more than $3,000 per night, with a median stipend of $1,000 per night to take call.

The statewide survey, conducted in the summer of 2005, showed coverage shortages in most specialties, with the most acute shortages in orthopedics and neurosurgery. More than half of all hospitals expressed difficulty in maintaining specialists on call for three or more specialties.

Orthopedists, neurosurgeons, and trauma surgeons were the specialists most likely to receive stipends, as reported in the survey. But survey author K. John McConnell, Ph.D., a researcher in emergency medicine at OHSU, noted that he also is beginning to hear about hand surgeons, obstetricians, otolaryngologists, and urologists asking to be paid to be on call.

Many specialists now have the opportunity to practice in a 9-to-5 setting, Dr. McConnell said, which makes them less willing to be on call. “There's no evil intent or bad guys—it's just everyone responding to changing dynamics,” he said.

Dr. Taylor agreed that lifestyle issues play a role in the shortage of on-call specialists and in their increasing demands to be paid for on-call duty. But he said that organizational and liability issues each play a bigger role. Hospitals and physicians must learn to arrange services and payment so that a specialist can be on call for 24 hours and then off the next day without losing income or hurting his or her own practice, Dr. Taylor said, adding that specialists “are starting to learn some lessons that emergency medicine learned years ago.”

The AHA has not taken a position on payment of specialists for being on call, but Ms. Steinberg said the group is sympathetic to physicians' problems. “We understand that physicians are being underpaid by Medicare and by private payers, and are facing huge professional liability,” she said.

Otolaryngologist Eric Furst of Springfield, Va., said that he and his ENT colleagues recently approached Inova Fairfax Hospital in an attempt to negotiate payment for being on call. Dr. Furst said that Inova Fairfax, the only level I trauma center in northern Virginia, requires its physicians to take call, and for his section, it amounts to a week at a time two times a year. Several ENT specialists have left because of the demands, he said, which increases the on-call burden for those who remain. “Before you know it, it is a huge financial hit in those weeks in your own practice,” he said.

After its 22 urologists threatened to stop responding to on-call care earlier this year, Inova Fairfax set up a fund to reimburse all 36 medical and surgical specialties that participate in emergency department on call for indigent care.

Uninsured Children Fare Worse

Injured, uninsured children who are hospitalized were twice as likely to die of their injuries as their insured counterparts, according to a new study from the advocacy group Families USA. Among children admitted with traumatic brain injury, uninsured children were more than twice as likely to die while in the hospital as insured children. Uninsured children also were less likely to get expensive treatment or rehabilitation, and were more likely to be discharged earlier, the report said. And, among children admitted to the hospital with otitis media, uninsured children were less than half as likely to get ear tubes inserted than insured children. “The clear implication of these groundbreaking data is that, when kids get hurt or sick, insurance matters,” said Families USA Executive Director Ron Pollack in a statement.

AAP Worried About HDHPs

High-deductible health plans could lead families to delay or avoid seeking care, meaning children may not get the preventive care they need for long-term good health, the American Academy of Pediatrics said in a policy statement. HDHPs provide a lower-cost policy in exchange for a very high deductible, often in the thousands of dollars. Some 20% of employers now offer HDHPs, many in lieu of more traditional policies that had included more preventive care benefits. “The financial risks are significant under HDHPs, especially for low- to moderate-income families and for families whose children have special health care needs,” AAP said in its policy statement. The academy noted that HDHPs should provide coverage for preventive services, including well-child care, immunizations, and appropriate screenings, without subjecting the cost of those services to the deductible.

Call to Action on Drinking

In its first Call to Action against underage drinking, the U.S. Surgeon General's office appealed to Americans to do more to stop the country's 11 million current underage drinkers from using alcohol, and to keep other young people from starting to drink. Acting Surgeon General Dr. Kenneth Moritsugu laid out recommendations for government and school officials, parents, other adults, and young people, saying that, while tobacco and illicit drug use has declined significantly, underage drinking as remained consistently high. “Research shows that young people who start drinking before the age of 15 are five times more likely to have alcohol-related problems later in life,” Dr. Moritsugu said in a statement, adding, “New research also indicates that alcohol may harm the developing adolescent brain.”

Booster Seat Laws Help

Children aged 4–7 in states with booster seat laws appear more likely to be appropriately restrained during car crashes than children in states without booster seat laws, according to a report in the Archives of Pediatrics & Adolescent Medicine. Motor vehicle accidents killed 350 children aged 4–7 in 2004, the article said. The authors compared data collected from 1998 to 2004 from both states that implemented booster seat laws and states that did not. They found that children aged 4–7 in states with booster seat laws were 39% more likely to be appropriately restrained in crashes. The increase in appropriate restraint was higher for 4− to 5-year-olds, the study found. “Future upgrades to child restraint laws should target all children through at least age 7 years to achieve the greatest effect on overall child restraint use,” the authors concluded.

Group Cautions States on Medicaid

States should pay critical attention to meeting the health needs of children as they contemplate health insurance coverage expansions and other changes to publicly funded programs, according to a new study from the advocacy group Commonwealth Fund. Comprehensive well-child services, such as those covered by Medicaid, play a critical role in preparing children for school and helping to determine how well they will do in life, said the study. The study calls on states considering any modifications to their programs to not only preserve what is already in place through Medicaid's Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program, but to actively work to ensure that children have access to a full array of high-quality preventive and developmental services. At a minimum, covered child health services should conform to AAP recommendations, the study said. In addition, states should create integrated systems of early childhood programs at the state and community level, and work to actively improve the quality of preventive pediatric care. States need to “make certain that children have access to care that will help them achieve their full potential,” said Commonwealth Fund President Karen Davis in a statement.

Uninsured Children Fare Worse

Injured, uninsured children who are hospitalized were twice as likely to die of their injuries as their insured counterparts, according to a new study from the advocacy group Families USA. Among children admitted with traumatic brain injury, uninsured children were more than twice as likely to die while in the hospital as insured children. Uninsured children also were less likely to get expensive treatment or rehabilitation, and were more likely to be discharged earlier, the report said. And, among children admitted to the hospital with otitis media, uninsured children were less than half as likely to get ear tubes inserted than insured children. “The clear implication of these groundbreaking data is that, when kids get hurt or sick, insurance matters,” said Families USA Executive Director Ron Pollack in a statement.

AAP Worried About HDHPs

High-deductible health plans could lead families to delay or avoid seeking care, meaning children may not get the preventive care they need for long-term good health, the American Academy of Pediatrics said in a policy statement. HDHPs provide a lower-cost policy in exchange for a very high deductible, often in the thousands of dollars. Some 20% of employers now offer HDHPs, many in lieu of more traditional policies that had included more preventive care benefits. “The financial risks are significant under HDHPs, especially for low- to moderate-income families and for families whose children have special health care needs,” AAP said in its policy statement. The academy noted that HDHPs should provide coverage for preventive services, including well-child care, immunizations, and appropriate screenings, without subjecting the cost of those services to the deductible.

Call to Action on Drinking

In its first Call to Action against underage drinking, the U.S. Surgeon General's office appealed to Americans to do more to stop the country's 11 million current underage drinkers from using alcohol, and to keep other young people from starting to drink. Acting Surgeon General Dr. Kenneth Moritsugu laid out recommendations for government and school officials, parents, other adults, and young people, saying that, while tobacco and illicit drug use has declined significantly, underage drinking as remained consistently high. “Research shows that young people who start drinking before the age of 15 are five times more likely to have alcohol-related problems later in life,” Dr. Moritsugu said in a statement, adding, “New research also indicates that alcohol may harm the developing adolescent brain.”

Booster Seat Laws Help

Children aged 4–7 in states with booster seat laws appear more likely to be appropriately restrained during car crashes than children in states without booster seat laws, according to a report in the Archives of Pediatrics & Adolescent Medicine. Motor vehicle accidents killed 350 children aged 4–7 in 2004, the article said. The authors compared data collected from 1998 to 2004 from both states that implemented booster seat laws and states that did not. They found that children aged 4–7 in states with booster seat laws were 39% more likely to be appropriately restrained in crashes. The increase in appropriate restraint was higher for 4− to 5-year-olds, the study found. “Future upgrades to child restraint laws should target all children through at least age 7 years to achieve the greatest effect on overall child restraint use,” the authors concluded.

Group Cautions States on Medicaid

States should pay critical attention to meeting the health needs of children as they contemplate health insurance coverage expansions and other changes to publicly funded programs, according to a new study from the advocacy group Commonwealth Fund. Comprehensive well-child services, such as those covered by Medicaid, play a critical role in preparing children for school and helping to determine how well they will do in life, said the study. The study calls on states considering any modifications to their programs to not only preserve what is already in place through Medicaid's Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program, but to actively work to ensure that children have access to a full array of high-quality preventive and developmental services. At a minimum, covered child health services should conform to AAP recommendations, the study said. In addition, states should create integrated systems of early childhood programs at the state and community level, and work to actively improve the quality of preventive pediatric care. States need to “make certain that children have access to care that will help them achieve their full potential,” said Commonwealth Fund President Karen Davis in a statement.

Uninsured Children Fare Worse

Injured, uninsured children who are hospitalized were twice as likely to die of their injuries as their insured counterparts, according to a new study from the advocacy group Families USA. Among children admitted with traumatic brain injury, uninsured children were more than twice as likely to die while in the hospital as insured children. Uninsured children also were less likely to get expensive treatment or rehabilitation, and were more likely to be discharged earlier, the report said. And, among children admitted to the hospital with otitis media, uninsured children were less than half as likely to get ear tubes inserted than insured children. “The clear implication of these groundbreaking data is that, when kids get hurt or sick, insurance matters,” said Families USA Executive Director Ron Pollack in a statement.

AAP Worried About HDHPs

High-deductible health plans could lead families to delay or avoid seeking care, meaning children may not get the preventive care they need for long-term good health, the American Academy of Pediatrics said in a policy statement. HDHPs provide a lower-cost policy in exchange for a very high deductible, often in the thousands of dollars. Some 20% of employers now offer HDHPs, many in lieu of more traditional policies that had included more preventive care benefits. “The financial risks are significant under HDHPs, especially for low- to moderate-income families and for families whose children have special health care needs,” AAP said in its policy statement. The academy noted that HDHPs should provide coverage for preventive services, including well-child care, immunizations, and appropriate screenings, without subjecting the cost of those services to the deductible.

Call to Action on Drinking

In its first Call to Action against underage drinking, the U.S. Surgeon General's office appealed to Americans to do more to stop the country's 11 million current underage drinkers from using alcohol, and to keep other young people from starting to drink. Acting Surgeon General Dr. Kenneth Moritsugu laid out recommendations for government and school officials, parents, other adults, and young people, saying that, while tobacco and illicit drug use has declined significantly, underage drinking as remained consistently high. “Research shows that young people who start drinking before the age of 15 are five times more likely to have alcohol-related problems later in life,” Dr. Moritsugu said in a statement, adding, “New research also indicates that alcohol may harm the developing adolescent brain.”

Booster Seat Laws Help

Children aged 4–7 in states with booster seat laws appear more likely to be appropriately restrained during car crashes than children in states without booster seat laws, according to a report in the Archives of Pediatrics & Adolescent Medicine. Motor vehicle accidents killed 350 children aged 4–7 in 2004, the article said. The authors compared data collected from 1998 to 2004 from both states that implemented booster seat laws and states that did not. They found that children aged 4–7 in states with booster seat laws were 39% more likely to be appropriately restrained in crashes. The increase in appropriate restraint was higher for 4− to 5-year-olds, the study found. “Future upgrades to child restraint laws should target all children through at least age 7 years to achieve the greatest effect on overall child restraint use,” the authors concluded.

Group Cautions States on Medicaid

States should pay critical attention to meeting the health needs of children as they contemplate health insurance coverage expansions and other changes to publicly funded programs, according to a new study from the advocacy group Commonwealth Fund. Comprehensive well-child services, such as those covered by Medicaid, play a critical role in preparing children for school and helping to determine how well they will do in life, said the study. The study calls on states considering any modifications to their programs to not only preserve what is already in place through Medicaid's Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program, but to actively work to ensure that children have access to a full array of high-quality preventive and developmental services. At a minimum, covered child health services should conform to AAP recommendations, the study said. In addition, states should create integrated systems of early childhood programs at the state and community level, and work to actively improve the quality of preventive pediatric care. States need to “make certain that children have access to care that will help them achieve their full potential,” said Commonwealth Fund President Karen Davis in a statement.

CMS Extends Form Deadline

The Centers for Medicare and Medicaid Services has extended the deadline for filing Medicare claims using its new version of claims form CMS-1500, because of formatting errors on the revised form, CMS announced. The original deadline for switching to the new form, known as CMS-1500 (08–05) originally was April 2. But CMS said last month that contractors have been directed to continue to accept the old form until the agency notifies them to stop. In addition, the agency advised physicians who must use the form to use legacy provider numbers as the form cannot accommodate a National Provider Identification (NPI) number.

Oncologist Shortfall Predicted

The United States will have a shortage of 2,550–4,080 oncologists by 2020—roughly one-quarter to one-third of the 2005 supply—as the demand for services increases by 48%, according to a report by the American Society of Clinical Oncology. Meanwhile, the supply of services provided by oncologists is expected to grow by just 14% by 2020, leading to a shortage representing up to 15 million visits per year. Options to fill the shortfall include redesigning service delivery, increasing fellowship positions and the use of nonphysician clinicians, and having primary care physicians provide more care for patients in remission. The report on the final results of the ASCO Oncology Workforce Study based its conclusions on the current age distribution and practice patterns of oncologists and the number of oncology fellowship positions.

Prescription Drug Sales Up

U.S. prescription drug sales grew more than 8% to $275 billion in 2006, fueled by the Medicare Part D prescription benefit, increased utilization of generics within new therapy classes, and new drug launches, said pharmaceutical data firm IMS Health. Total dispensed prescriptions grew at nearly a 5% pace, compared with slightly more than 3% in 2005, the firm said. Part D was a large driver of the upward trend, lifting prescription volume by an estimated 1 to 2 percentage points and pharmaceutical sales by about 1 percentage point. The benefit “increased prescription coverage to the previously uninsured and underinsured, and provided generous plan benefits to seniors,” said Diana Conmy, corporate director, IMS Market Insights, in a statement. Meanwhile, drug makers released new generic forms of lipid regulators, antidepressants, and inhaled steroids, resulting in significant growth for those classes of medications. Sales of prescription drugs in the United States are expected to decline in 2007, IMS Health said.

Veterans Bill Introduced

Veterans with service-connected disabilities would be able to go to the hospital or medical clinic of their choice under legislation introduced by Sen. Larry Craig (R-Idaho). The senator said he was concerned about the care lapses documented at Walter Reed Hospital in Washington, but said that he was willing to pit the health care system run by the U.S. Department of Veterans Affairs against private sector providers because he considered the VA system among the best in the nation. “This bill is about my confidence in the VA,” Sen. Craig said in a statement. “Let's see where veterans choose to go. It's very simple: If service-connected veterans leave in droves, we've learned something. But, if veterans overwhelmingly stay, and I think they will, we've also learned something.”

Medical Debt Increasing

Families are turning to credit cards to pay for medical care as health care costs continue to rise faster than incomes, according to new research by public policy advocacy groups Demos and the Access Project. The groups found that 29% of low- and middle-income households with credit card debt reported that medical expenses contributed to their current balances, and within that group, 69% had a major medical expense in the previous 3 years. Low- and middle-income medically indebted households had, on average, 46% higher levels of credit card debt than those without medical debt. In addition, the medically indebted were almost twice as likely to be called by bill collectors than were the nonmedically indebted. “Congress should address this new and serious consequence of our nation's growing health care crisis before more families go into debt, and risk their financial stability, to get the medical care they need,” said report coauthor Cindy Zeldin of Demos in a statement.

Drug Executives Admit Fraud

Four executives from the bankrupt generic drug maker Able Laboratories Inc., pleaded guilty in March to roles in a 7-year scheme to falsify data at the company, which had made 46 generic versions of brand-name, mostly prescription drugs for pain, inflammation, obesity, and cardiovascular conditions. The highest ranking official of the four, Shashikant Shah, vice president for quality control and regulatory affairs, also pleaded guilty to a securities fraud charge. The Food and Drug Administration has said that the company, based in Cranbury, N.J., invented data so its drugs would appear to meet federal standards when in fact they had too much or too little of their active ingredients. This occurred 41 times dating back to 2001, while on nine other occasions, Able failed to issue alerts about impure drugs. Able, which recalled all of its prescription products in May 2005 as part of an agreement with the FDA, filed for bankruptcy protection in July 2005 and liquidated its assets in March 2006.

CMS Extends Form Deadline

The Centers for Medicare and Medicaid Services has extended the deadline for filing Medicare claims using its new version of claims form CMS-1500, because of formatting errors on the revised form, CMS announced. The original deadline for switching to the new form, known as CMS-1500 (08–05) originally was April 2. But CMS said last month that contractors have been directed to continue to accept the old form until the agency notifies them to stop. In addition, the agency advised physicians who must use the form to use legacy provider numbers as the form cannot accommodate a National Provider Identification (NPI) number.

Oncologist Shortfall Predicted

The United States will have a shortage of 2,550–4,080 oncologists by 2020—roughly one-quarter to one-third of the 2005 supply—as the demand for services increases by 48%, according to a report by the American Society of Clinical Oncology. Meanwhile, the supply of services provided by oncologists is expected to grow by just 14% by 2020, leading to a shortage representing up to 15 million visits per year. Options to fill the shortfall include redesigning service delivery, increasing fellowship positions and the use of nonphysician clinicians, and having primary care physicians provide more care for patients in remission. The report on the final results of the ASCO Oncology Workforce Study based its conclusions on the current age distribution and practice patterns of oncologists and the number of oncology fellowship positions.

Prescription Drug Sales Up

U.S. prescription drug sales grew more than 8% to $275 billion in 2006, fueled by the Medicare Part D prescription benefit, increased utilization of generics within new therapy classes, and new drug launches, said pharmaceutical data firm IMS Health. Total dispensed prescriptions grew at nearly a 5% pace, compared with slightly more than 3% in 2005, the firm said. Part D was a large driver of the upward trend, lifting prescription volume by an estimated 1 to 2 percentage points and pharmaceutical sales by about 1 percentage point. The benefit “increased prescription coverage to the previously uninsured and underinsured, and provided generous plan benefits to seniors,” said Diana Conmy, corporate director, IMS Market Insights, in a statement. Meanwhile, drug makers released new generic forms of lipid regulators, antidepressants, and inhaled steroids, resulting in significant growth for those classes of medications. Sales of prescription drugs in the United States are expected to decline in 2007, IMS Health said.

Veterans Bill Introduced

Veterans with service-connected disabilities would be able to go to the hospital or medical clinic of their choice under legislation introduced by Sen. Larry Craig (R-Idaho). The senator said he was concerned about the care lapses documented at Walter Reed Hospital in Washington, but said that he was willing to pit the health care system run by the U.S. Department of Veterans Affairs against private sector providers because he considered the VA system among the best in the nation. “This bill is about my confidence in the VA,” Sen. Craig said in a statement. “Let's see where veterans choose to go. It's very simple: If service-connected veterans leave in droves, we've learned something. But, if veterans overwhelmingly stay, and I think they will, we've also learned something.”

Medical Debt Increasing

Families are turning to credit cards to pay for medical care as health care costs continue to rise faster than incomes, according to new research by public policy advocacy groups Demos and the Access Project. The groups found that 29% of low- and middle-income households with credit card debt reported that medical expenses contributed to their current balances, and within that group, 69% had a major medical expense in the previous 3 years. Low- and middle-income medically indebted households had, on average, 46% higher levels of credit card debt than those without medical debt. In addition, the medically indebted were almost twice as likely to be called by bill collectors than were the nonmedically indebted. “Congress should address this new and serious consequence of our nation's growing health care crisis before more families go into debt, and risk their financial stability, to get the medical care they need,” said report coauthor Cindy Zeldin of Demos in a statement.

Drug Executives Admit Fraud

Four executives from the bankrupt generic drug maker Able Laboratories Inc., pleaded guilty in March to roles in a 7-year scheme to falsify data at the company, which had made 46 generic versions of brand-name, mostly prescription drugs for pain, inflammation, obesity, and cardiovascular conditions. The highest ranking official of the four, Shashikant Shah, vice president for quality control and regulatory affairs, also pleaded guilty to a securities fraud charge. The Food and Drug Administration has said that the company, based in Cranbury, N.J., invented data so its drugs would appear to meet federal standards when in fact they had too much or too little of their active ingredients. This occurred 41 times dating back to 2001, while on nine other occasions, Able failed to issue alerts about impure drugs. Able, which recalled all of its prescription products in May 2005 as part of an agreement with the FDA, filed for bankruptcy protection in July 2005 and liquidated its assets in March 2006.

CMS Extends Form Deadline

The Centers for Medicare and Medicaid Services has extended the deadline for filing Medicare claims using its new version of claims form CMS-1500, because of formatting errors on the revised form, CMS announced. The original deadline for switching to the new form, known as CMS-1500 (08–05) originally was April 2. But CMS said last month that contractors have been directed to continue to accept the old form until the agency notifies them to stop. In addition, the agency advised physicians who must use the form to use legacy provider numbers as the form cannot accommodate a National Provider Identification (NPI) number.

Oncologist Shortfall Predicted

The United States will have a shortage of 2,550–4,080 oncologists by 2020—roughly one-quarter to one-third of the 2005 supply—as the demand for services increases by 48%, according to a report by the American Society of Clinical Oncology. Meanwhile, the supply of services provided by oncologists is expected to grow by just 14% by 2020, leading to a shortage representing up to 15 million visits per year. Options to fill the shortfall include redesigning service delivery, increasing fellowship positions and the use of nonphysician clinicians, and having primary care physicians provide more care for patients in remission. The report on the final results of the ASCO Oncology Workforce Study based its conclusions on the current age distribution and practice patterns of oncologists and the number of oncology fellowship positions.

Prescription Drug Sales Up

U.S. prescription drug sales grew more than 8% to $275 billion in 2006, fueled by the Medicare Part D prescription benefit, increased utilization of generics within new therapy classes, and new drug launches, said pharmaceutical data firm IMS Health. Total dispensed prescriptions grew at nearly a 5% pace, compared with slightly more than 3% in 2005, the firm said. Part D was a large driver of the upward trend, lifting prescription volume by an estimated 1 to 2 percentage points and pharmaceutical sales by about 1 percentage point. The benefit “increased prescription coverage to the previously uninsured and underinsured, and provided generous plan benefits to seniors,” said Diana Conmy, corporate director, IMS Market Insights, in a statement. Meanwhile, drug makers released new generic forms of lipid regulators, antidepressants, and inhaled steroids, resulting in significant growth for those classes of medications. Sales of prescription drugs in the United States are expected to decline in 2007, IMS Health said.

Veterans Bill Introduced

Veterans with service-connected disabilities would be able to go to the hospital or medical clinic of their choice under legislation introduced by Sen. Larry Craig (R-Idaho). The senator said he was concerned about the care lapses documented at Walter Reed Hospital in Washington, but said that he was willing to pit the health care system run by the U.S. Department of Veterans Affairs against private sector providers because he considered the VA system among the best in the nation. “This bill is about my confidence in the VA,” Sen. Craig said in a statement. “Let's see where veterans choose to go. It's very simple: If service-connected veterans leave in droves, we've learned something. But, if veterans overwhelmingly stay, and I think they will, we've also learned something.”

Medical Debt Increasing

Families are turning to credit cards to pay for medical care as health care costs continue to rise faster than incomes, according to new research by public policy advocacy groups Demos and the Access Project. The groups found that 29% of low- and middle-income households with credit card debt reported that medical expenses contributed to their current balances, and within that group, 69% had a major medical expense in the previous 3 years. Low- and middle-income medically indebted households had, on average, 46% higher levels of credit card debt than those without medical debt. In addition, the medically indebted were almost twice as likely to be called by bill collectors than were the nonmedically indebted. “Congress should address this new and serious consequence of our nation's growing health care crisis before more families go into debt, and risk their financial stability, to get the medical care they need,” said report coauthor Cindy Zeldin of Demos in a statement.

Drug Executives Admit Fraud

Four executives from the bankrupt generic drug maker Able Laboratories Inc., pleaded guilty in March to roles in a 7-year scheme to falsify data at the company, which had made 46 generic versions of brand-name, mostly prescription drugs for pain, inflammation, obesity, and cardiovascular conditions. The highest ranking official of the four, Shashikant Shah, vice president for quality control and regulatory affairs, also pleaded guilty to a securities fraud charge. The Food and Drug Administration has said that the company, based in Cranbury, N.J., invented data so its drugs would appear to meet federal standards when in fact they had too much or too little of their active ingredients. This occurred 41 times dating back to 2001, while on nine other occasions, Able failed to issue alerts about impure drugs. Able, which recalled all of its prescription products in May 2005 as part of an agreement with the FDA, filed for bankruptcy protection in July 2005 and liquidated its assets in March 2006.

American consumers and their employers are treading cautiously when it comes to switching from traditional, more comprehensive health insurance to consumer-driven health plans, with few actually adopting the new plans, according to survey results from the Employee Benefit Research Institute (EBRI) and the Commonwealth Fund.

In addition, satisfaction among members in consumer-driven health plans (CDHPs) was considerably lower than satisfaction among individuals in more traditional plans, and more members in CDHPs reported that they had delayed getting needed medical care.

The Consumerism in Health Care Survey tracks public opinion on consumer-driven and high-deductible plans, defined as those plans with deductibles of $1,000 or more for employee-only coverage and $2,000 or more for family coverage. The plans also feature one of two kinds of tax-exempt savings accounts: health savings accounts (HSAs) and health reimbursement arrangements (HRAs).

Employees can use money in the accounts without tax penalty to pay for medical expenses not covered by their health plans.

“Consumer-driven health plans aim to control costs largely through demand-side incentives, and to make premiums more affordable for the uninsured,” said Karen Davis, Ph.D., president of the Commonwealth Fund, at a press teleconference sponsored by EBRI and the Commonwealth Fund.

But the survey found that the plans have been slow to catch on. Just 1% of the privately insured U.S. population aged 21–64 years, or 1.3 million individuals, were enrolled in CDHPs in September 2006, unchanged from the year before—despite the widespread attention the new plans have received.

And although another 7% (8.5 million adults) had plans with deductibles that were high enough to qualify for health savings accounts, they were not enrolled in such accounts.

Employers are cautiously awaiting data on the cost and effectiveness of these kinds of plans before switching their coverage to CDHPs, Dr. Davis said.

“The plans are not well known at this point,” said Paul Fronstin, EBRI senior research associate. “Only 7% of the population responded that they are 'very familiar' with consumer-directed health plans, while 13% said they were 'somewhat familiar.'”

In addition, despite the expectations of some policy makers that the lower premiums and tax benefits of CDHPs would substantially reduce the number of people without health insurance, “we did find that individuals in consumer-directed plans were not more likely to have been uninsured than those enrolled in a conventional plan,” Mr. Fronstin said.

Satisfaction lags in the plans, compared with more comprehensive health insurance, the survey found.

And, 38% of those with consumer-driven coverage said that they delayed or avoided getting needed health care because of cost over the last 12 months, compared with 19% of those with comprehensive insurance.

It's no surprise that employers and employees have been cautious in adopting CDHPs, because effecting change in the health insurance industry can be a very difficult undertaking, said Karen Atwood, senior vice president for national accounts at Blue Cross and Blue Shield of Illinois.

“We are in the early stages of trying to understand how consumerism can be part of the solution,” said Ms. Atwood, who noted that such plans also need to have tools in place to address lifestyle behaviors and choices.

“We need good plans, well-crafted network options, and incentives to reward people for doing the right thing,” she added.

The survey of 3,158 U.S. adults aged 21–64 was conducted in September through a 14-minute Internet survey.

American consumers and their employers are treading cautiously when it comes to switching from traditional, more comprehensive health insurance to consumer-driven health plans, with few actually adopting the new plans, according to survey results from the Employee Benefit Research Institute (EBRI) and the Commonwealth Fund.

In addition, satisfaction among members in consumer-driven health plans (CDHPs) was considerably lower than satisfaction among individuals in more traditional plans, and more members in CDHPs reported that they had delayed getting needed medical care.

The Consumerism in Health Care Survey tracks public opinion on consumer-driven and high-deductible plans, defined as those plans with deductibles of $1,000 or more for employee-only coverage and $2,000 or more for family coverage. The plans also feature one of two kinds of tax-exempt savings accounts: health savings accounts (HSAs) and health reimbursement arrangements (HRAs).

Employees can use money in the accounts without tax penalty to pay for medical expenses not covered by their health plans.

“Consumer-driven health plans aim to control costs largely through demand-side incentives, and to make premiums more affordable for the uninsured,” said Karen Davis, Ph.D., president of the Commonwealth Fund, at a press teleconference sponsored by EBRI and the Commonwealth Fund.

But the survey found that the plans have been slow to catch on. Just 1% of the privately insured U.S. population aged 21–64 years, or 1.3 million individuals, were enrolled in CDHPs in September 2006, unchanged from the year before—despite the widespread attention the new plans have received.

And although another 7% (8.5 million adults) had plans with deductibles that were high enough to qualify for health savings accounts, they were not enrolled in such accounts.

Employers are cautiously awaiting data on the cost and effectiveness of these kinds of plans before switching their coverage to CDHPs, Dr. Davis said.

“The plans are not well known at this point,” said Paul Fronstin, EBRI senior research associate. “Only 7% of the population responded that they are 'very familiar' with consumer-directed health plans, while 13% said they were 'somewhat familiar.'”

In addition, despite the expectations of some policy makers that the lower premiums and tax benefits of CDHPs would substantially reduce the number of people without health insurance, “we did find that individuals in consumer-directed plans were not more likely to have been uninsured than those enrolled in a conventional plan,” Mr. Fronstin said.

Satisfaction lags in the plans, compared with more comprehensive health insurance, the survey found.

And, 38% of those with consumer-driven coverage said that they delayed or avoided getting needed health care because of cost over the last 12 months, compared with 19% of those with comprehensive insurance.

It's no surprise that employers and employees have been cautious in adopting CDHPs, because effecting change in the health insurance industry can be a very difficult undertaking, said Karen Atwood, senior vice president for national accounts at Blue Cross and Blue Shield of Illinois.

“We are in the early stages of trying to understand how consumerism can be part of the solution,” said Ms. Atwood, who noted that such plans also need to have tools in place to address lifestyle behaviors and choices.

“We need good plans, well-crafted network options, and incentives to reward people for doing the right thing,” she added.

The survey of 3,158 U.S. adults aged 21–64 was conducted in September through a 14-minute Internet survey.

American consumers and their employers are treading cautiously when it comes to switching from traditional, more comprehensive health insurance to consumer-driven health plans, with few actually adopting the new plans, according to survey results from the Employee Benefit Research Institute (EBRI) and the Commonwealth Fund.

In addition, satisfaction among members in consumer-driven health plans (CDHPs) was considerably lower than satisfaction among individuals in more traditional plans, and more members in CDHPs reported that they had delayed getting needed medical care.

The Consumerism in Health Care Survey tracks public opinion on consumer-driven and high-deductible plans, defined as those plans with deductibles of $1,000 or more for employee-only coverage and $2,000 or more for family coverage. The plans also feature one of two kinds of tax-exempt savings accounts: health savings accounts (HSAs) and health reimbursement arrangements (HRAs).

Employees can use money in the accounts without tax penalty to pay for medical expenses not covered by their health plans.

“Consumer-driven health plans aim to control costs largely through demand-side incentives, and to make premiums more affordable for the uninsured,” said Karen Davis, Ph.D., president of the Commonwealth Fund, at a press teleconference sponsored by EBRI and the Commonwealth Fund.

But the survey found that the plans have been slow to catch on. Just 1% of the privately insured U.S. population aged 21–64 years, or 1.3 million individuals, were enrolled in CDHPs in September 2006, unchanged from the year before—despite the widespread attention the new plans have received.

And although another 7% (8.5 million adults) had plans with deductibles that were high enough to qualify for health savings accounts, they were not enrolled in such accounts.

Employers are cautiously awaiting data on the cost and effectiveness of these kinds of plans before switching their coverage to CDHPs, Dr. Davis said.

“The plans are not well known at this point,” said Paul Fronstin, EBRI senior research associate. “Only 7% of the population responded that they are 'very familiar' with consumer-directed health plans, while 13% said they were 'somewhat familiar.'”

In addition, despite the expectations of some policy makers that the lower premiums and tax benefits of CDHPs would substantially reduce the number of people without health insurance, “we did find that individuals in consumer-directed plans were not more likely to have been uninsured than those enrolled in a conventional plan,” Mr. Fronstin said.

Satisfaction lags in the plans, compared with more comprehensive health insurance, the survey found.

And, 38% of those with consumer-driven coverage said that they delayed or avoided getting needed health care because of cost over the last 12 months, compared with 19% of those with comprehensive insurance.

It's no surprise that employers and employees have been cautious in adopting CDHPs, because effecting change in the health insurance industry can be a very difficult undertaking, said Karen Atwood, senior vice president for national accounts at Blue Cross and Blue Shield of Illinois.

“We are in the early stages of trying to understand how consumerism can be part of the solution,” said Ms. Atwood, who noted that such plans also need to have tools in place to address lifestyle behaviors and choices.

“We need good plans, well-crafted network options, and incentives to reward people for doing the right thing,” she added.

The survey of 3,158 U.S. adults aged 21–64 was conducted in September through a 14-minute Internet survey.