AAFP News Now: AFP Edition
Policy and Health Issues in the News
Am Fam Physician. 2009 Sep 1;80(5):433-434.
Organizations Develop Resources, Issue Recommendations for Fall Flu Vaccinations
The Centers for Disease Control and Prevention's (CDC's) Advisory Committee on Immunization Practices (ACIP) has released targeted recommendations for the novel influenza A (H1N1) vaccine when it becomes available in October 2009. During an emergency meeting to address issues surrounding the H1N1 virus, ACIP recommended that vaccination efforts focus on five populations: pregnant women, persons who live with or care for children younger than six months; health care and emergency services personnel; persons six months to 24 years of age; and persons 25 to 64 years of age who have chronic health conditions or compromised immune systems. The targeted groups account for about 159 million persons, and only 120 million doses of H1N1 vaccine are expected to be available by October. However, the CDC does not anticipate a vaccine shortage, based on the percentage of Americans who receive annual seasonal influenza vaccination. To increase vaccination awareness, the American Academy of Family Physicians (AAFP) is featuring an online collection of articles on a variety of vaccine-related topics, including improving vaccination rates among children, adolescents, health care workers, and pregnant women. The Web site also offers links to vaccine statistics and immunization resources. For more information, visit http://www.aafp.org/news-now/clinical-care-research/20090731h1n1-vacc-grps.html or http://www.aafp.org/news-now/vaccine.html.
Report Outlines Unnecessary Health Care Spending, Offers Tips for Cutting Costs
The United States could save billions of dollars in health care costs by cutting through administrative red tape, according to a report from the Healthcare Administrative Simplification Coalition (HASC). Approximately 25 percent of the nation's health care costs go toward administrative functions, such as billing and payment tasks, instead of toward hands-on patient care. Medical Group Management Association President and CEO William Jessee, MD, explained that although the United States spends more money on health care than any other country, the United States gets less value because of unnecessarily complex administrative processes. In its report, HASC outlines recommendations for reducing wasteful spending, including simplifying the physician credentialing process; streamlining claims processing; standardizing patient identification cards; and improving the prior authorization process for radiology and pharmacy services. For more information and a list of specific recommendations, visit http://www.aafp.org/news-now/practice-management/20090804hascrpt.html.
Proposed CMS Rule Would Affect Solvency of Family Medicine Residency Programs
A proposed rule from the Centers for Medicare and Medicaid Services (CMS) regarding new residency training programs has drawn criticism from the AAFP and organizations in the Academic Family Medicine Advocacy Alliance. The rule is based on a CMS decision from March 2009 to end funding for graduate medical education (GME) at the Stanislaus Family Medicine Residency Program in Modesto, Calif. In 1997, the residency moved to a new facility from a country hospital that was forced to close, and CMS reclassified the residency as a new program. In 2007, CMS reevaluated the residency, leading to the decision to discontinue Medicare support for GME at the residency and ask for $19 million in Medicare repayments. If the rule stands, CMS would be allowed to reclassify any residency program that leaves one sponsoring hospital and moves to another. Without federal GME money, sponsoring facilities would be unable to support the residencies. In a letter to CMS, the AAFP and other groups in the family medicine alliance indicated that the proposed rule would lead to more closings of family medicine residencies and losses of first-year family medicine residency slots. For more information, visit http://www.aafp.org/news-now/resident-student-focus/20090729cms-gme-proprule.html.
Study Shows Prevalence of Obesity Increases While Associated Costs Rise
Costs attributable to obesity may have reached $147 billion in 2008, up from $78.5 billion in 1998, according to a July 27, 2009, report from the CDC and the Research Triangle Institute. Data show that the costs associated with obesity are the result of treating diseases that obesity promotes, such as diabetes. In 2000, the U.S. Department of Health and Human Services (HHS) set a goal in its Healthy People 2010 program to reduce the prevalence of obesity in adults to 15 percent or less. However, more than one fourth of U.S. adults are obese, and Colorado is the only state where the prevalence of adult obesity is less than 20 percent. According to data from the CDC's Behavioral Risk Factor Surveillance System, 26.1 percent of U.S. adults were obese in 2008, up from 25.6 percent one year earlier. The prevalence of adult obesity was 30 percent or more in Alabama, Mississippi, Oklahoma, South Carolina, Tennessee, and West Virginia. The American Recovery and Reinvestment Act (ARRA) provides $1 billion for medical prevention programs, of which a significant amount will go toward helping state and local agencies address obesity and other public health challenges. For more information, visit http://www.aafp.org/news-now/health-of-the-public/20090810obesity.html or read the complete study at http://content.healthaffairs.org/cgi/content/short/hlthaff.28.5.w822.
New Software Lets Physicians Access OTC Drug Information from Smartphones
Physicians can now download information about hundreds of brand-name over-the-counter (OTC) medications with their smartphones. The mobile software from Epocrates Inc. provides information on drug interactions, proper dosing, formulations, flavors, and alternatives. Additionally, the software can identify products considered safe for pregnant women or patients with diabetes, as well as products covered by Medicare Part D and other health plans. The database can be downloaded for free with a subscription to any Epocrates premium product. For more information, visit http://www.aafp.org/news-now/practice-management/20090729epocrates-otc.html.
FDA Issues Warning About Toxins, Carcinogens in Electronic Cigarettes
The U.S. Food and Drug Administration (FDA) has issued a warning about health risks associated with electronic cigarettes (e-cigarettes). E-cigarettes are battery-operated devices designed to look and function like regular cigarettes by turning nicotine and other chemicals into a vapor that is inhaled. Although manufacturers have touted them as safer than conventional cigarettes, an FDA analysis showed detectable levels of carcinogens and toxic chemicals in two brands. E-cigarettes are sold without legal age restrictions and do not contain health warnings comparable to those found on FDA-approved nicotine replacement products or conventional cigarettes. For more information, visit http://www.aafp.org/news-now/health-of-the-public/20090728e-cigarettes.html.
Medicaid Participants with EHR System May Qualify for Bonus Payments
A new report from the Geiger Gibson/RCHN Community Health Foundation Research Collaborative estimates that 45,000 office-based physicians, including 9,800 primary care physicians, who participate in Medicaid and use an electronic health record (EHR) system could collect up to $63,750 over a six-year period. The Medicaid bonuses, which are part of ARRA, are significantly higher than the $44,000 maximum provided by a similar Medicare program. To qualify for the Medicaid bonuses, physicians must use a certified EHR system and have at least 30 percent of their patient panel enrolled in Medicaid. The HHS is investing $49 billion in Medicare and Medicaid programs to ensure that 40 percent of U.S. physicians are up-to-date with health information technology by 2012. For more information, visit http://www.aafp.org/news-now/government-medicine/20090810medicaid-ehr-bonus.html.
CCRN Seeks Practices to Study Mental Health Services in Primary Care Settings
Practices looking to investigate and evaluate the integration of mental health services in primary care settings can now enroll in the AAFP's Collaborative Care Research Network (CCRN), a new subset of the National Research Network. According to a study in the May-June 2009 issue of Health Affairs, two thirds of primary care physicians do not have access to mental health subspecialists because of barriers, such as a lack of mental health professionals and insurance restrictions. The CCRN is studying a new treatment model that would involve in-house medical teams working together to plan treatment and execute patient care. CCRN Research Director Rodger Kessler, PhD, expects that combining mental health, substance abuse, and physical health services will produce better outcomes than the referral system. Currently, the CCRN has recruited 30 practices and hopes to add 50 practices per year during the next two years. For more information, visit http://www.aafp.org/news-now/clinical-care-research/20090805ccrnlaunch.html.
FTC Delays Enforcement of Identify Theft ‘Red Flags’ Rule Until November 2009
The Federal Trade Commission (FTC) announced that it has once again delayed the enforcement of the Identity Theft “Red Flags” Rule, pushing the deadline back to November 1, 2009. The rule is an antifraud regulation administered by the FTC that requires financial institutions and creditors, including physician practices, to develop and implement written identity theft prevention programs as part of the Fair and Accurate Credit Transactions Act of 2003. According to the FTC, the new deadline will allow the commission to increase its efforts to educate businesses about the rule by providing more resources and compliance guidelines. For more information, visit http://www.aafp.org/news-now/practice-management/20090730red-flags-novdelay.html.
— AFP and AAFP NEWS NOW staff
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