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Policy and Health Issues in the News
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Am Fam Physician. 2008 Jun 1;77(11):1499-1500.
Bipartisan Legislation Could Help Launch Health Care Reform in Next Administration
The Senate Finance Committee is considering a bill that could become a vehicle for health care reform in the next presidential administration. Sen. Ron Wyden (D-Ore.) introduced the Healthy Americans Act (S.B. 334) in January 2007. Proponents hope the bipartisan bill will point the new administration in the right direction toward creating a patient-driven health care system. Len Nichols, PhD, director of the health policy program for the New American Foundation says that the bill reflects changing attitudes among Democrats and Republicans on the issue of health care reform. Democrats are focused on changing health care through markets and choices, says Nichols, and Republicans are focused on making health insurance more affordable and accessible. The bill would require adults to carry health insurance, promoting universal coverage, and aims to reduce costs and make the delivery system more efficient through individual choices, market incentives, and reform. The legislation also encourages Medicare beneficiaries to choose a medical home and pays physician practices for serving as medical homes. For more information, visit http://www.aafp.org/news-now/government-medicine/20080425wydenbill.html.
New Bill Would Bar Patient Discrimination Based on the Results of Genetic Testing
A new bill under consideration in the House would prohibit employers from making hiring, assignment, or promotion decisions based on genetic test data. Similarly, the bill would prevent insurers from making coverage or premium decisions based on these data; insurers also would not be permitted to request or purchase beneficiaries' genetic test results. The Genetic Information Non-discrimination Act of 2008 (H.R. 493) passed the Senate in a unanimous vote, and President Bush has indicated that he would sign the bill. Advances in genetic testing over the past several years has created more interest among the general public; however, some of this progress has stalled because patients fear discrimination based on their test results. Sen. Olympia Snowe (R-Maine), sponsor of the bill, says that it is a significant step forward in decreasing patient discrimination and would allow patients to take advantage of genetic testing without fear of repercussions. Although Congress has been unable to pass similar bills over that past decade, the current bill has had overwhelming support in both the House and Senate and from disparate stakeholders. For more information, visit http://www.aafp.org/news-now/government-medicine/20080502geneticsbill.html.
COGME Reports Focus on National Medical School System and Access to Health Care
The Council on Graduate Medical Education (COGME) recently released two consensus reports. The first report, “New Paradigms for Physician Training for Improving Access to Health Care,” includes five recommendations to the U.S. Department of Health and Human Services (HHS) and Congress. Specifically, it recommends that the United States establish a national medical school system that would provide tuition-free education to students who agree to practice in underserved areas. Although the report does not indicate how long the graduate would be asked to practice in the underserved area, it aims to improve access to care for patients in rural areas and for uninsured patients in urban areas. The proposed national medical school model would focus on service, public health issues, epidemiology, and emergency preparedness and response. The second report, “Enhancing Flexibility in Graduate Medical Education,” builds on the first report and includes recommendations about the content, structure, and setting of graduate medical education training. It recommends directing funds and support toward innovative training models, such as those presented in the family medicine's residency demonstration initiative (http://www.transformed.com/p4.cfm). Both reports call for funding of Title VII education programs. For more information, visit http://www.aafp.org/news-now/resident-student-focus/20080430cogmereports.html.
Grants Aim to Provide Alternative Health Care Settings for Nonemergent Visits
The Centers for Medicare and Medicaid Services (CMS) recently announced $50 million in grants to help Medicaid beneficiaries receive nonemergent care in the primary care setting, instead of in the emergency department. The grants were created by the Deficit Reduction Act of 2005 to be distributed over four years to primary health care programs, primarily those in underserved areas and that work with community hospitals. Medicare programs will use the funds to provide appropriate health care settings for patients with nonemergent needs living in underserved areas, which will decrease the improper use of costly emergency department visits. Grantees in 20 states will establish new community health centers, extend office hours for existing clinics, educate beneficiaries about new services, and establish better coordination of care through electronic health information exchanges. CMS Acting Administrator Kerry Weems says that the organization continues to work with communities to slow spending without decreasing health care coverage. For more information, visit the CMS Web site at http://www.cms.hhs.gov/GrantsAlternaNonEmergServ.
Tool Assesses Practices' Progress Toward Patient-Centered Medical Home Model
TransforMED has launched a free online tool that measures how well practices are progressing toward a patient-centered medical home. The Medical Home Implementation Quotient (MHIQ) consists of eight modules with 13 to 30 questions; each module takes about 15 minutes to complete. The MHIQ replaces the shorter version launched in January 2007. The questions focus on practice procedures and enhancements in health information technology, practice management, quality and safety, team-based care, point-of-care services, continuity of care, access to care, and patient-centered care. The tool is comprehensive, allowing users to retain the results and tabulate progress each time new data are added. TransforMED President and CEO Terry McGeeney, MD, MBA, says that high-scoring practices are poised to become recognized patient-centered medical homes, which reflects positive change and possible financial incentives in the future. MHIQ is a work in progress, and TransforMED will make alterations to the system as more physicians use the tool and provide feedback. For more information, visit http://www.aafp.org/news-now/practice-management/20080508tmed-mhiq.html or the TransforMED Web site at http://www.transformed.com/MHIQ/welcome.cfm.
CMS Offers More Reporting Flexibility to Promote Increased PQRI Participation
Changes to CMS' Physician Quality Reporting Initiative (PQRI) should make it easier for health care professionals to submit quality measurement data. Under the Medicare, Medicaid and State Children's Health Insurance Program Extension Act of 2007, HHS is required to establish alternative PQRI criteria and reporting periods for 2008. In the 2008 program, eligible participants may continue to report quality data as part of the Medicare claims submission process or through a patient registry that would send the data to CMS. Participants will also have the option of reporting on group measures, instead of on individual measures. In March, CMS reported that 15.74 percent of all eligible health care professionals attempted to participate in the 2007 program. Although CMS is encouraged by the 2007 participation, it hopes the changes will prompt more physicians to take advantage of the program in 2008. For more information, visit http://www.aafp.org/news-now/practice-management/20080425pqrioptions.html or the CMS Web site at http://www.cms.hhs.gov/PQRI.
Speech by Former Surgeon General Focuses on Physicians' Role in Health Care Reform
During the American Academy of Family Physicians 2008 National Conference of Special Constituencies, former U.S. Surgeon General Joycelyn Elders, MD, called on physicians to take action to change the health care system. She also emphasized the major problems with the current system, including the lack of universal insurance coverage; a shortage of primary care, rural, and minority physicians; and disparities among different cultural and socioeconomic groups. Elders' main message centered on physicians addressing the inadequate system by developing leadership strategies and delivering a clear, accurate message. For more information, visit http://www.aafp.org/news-now/inside-aafp/20080508elders-ncsc.html.
Resource Allows Physicians To Exchange Information About Health Care Innovations
A new Web resource from the Agency for Healthcare Research and Quality (AHRQ) provides a venue for physicians to share information about developments in health care. The Health Care Innovations Exchange launched in April with 100 examples of successful innovations, and it will be updated every two weeks. The Web site is also the new home for AHRQ's Quality Initiative tools. For more information, visit the AHRQ Web site at http://www.ahrq.gov/news/press/pr2008/innovationspr.htm or http://www.innovations.ahrq.gov.
CDC Announces Availability of 400-mg Cefixime Tablets in the United States
The only oral drug recommended by the Centers for Disease Control and Prevention (CDC) for the treatment of uncomplicated urogenital or rectal gonorrhea has returned to the U.S. market. The 400-mg cefixime tablets have had limited availability since 2002 when Wyeth Pharmaceuticals discontinued manufacturing them. Although cefixime injections have been available, Lupin Pharmaceuticals is now providing 400-mg tablets. For more information, visit http://www.aafp.org/news-now/clinical-care-research/20080430cefixime.html or the CDC Web site at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5716a5.htm.
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