This roundup includes the following news briefs:
On Oct. 10, AAFP leaders met with representatives from UnitedHealth Group and its subsidiaries, UnitedHealthcare and Optum, to discuss payment issues, distressed practice environments, and paying fee-for-service rates below Medicare rates.
According to a blog entry from AAFP President Glen Stream, M.D., M.B.I., of Spokane, Wash., who was present at the meeting "Many health plans are offering family medicine practices -- especially in rural areas and in areas with small- and medium-sized practices -- contracts for fee-for-service payment that are up to 40 percent less than Medicare. Sadly, these practices have no room to negotiate. It's take it or leave it. We told United's representatives that such tactics are outrageous. This approach is killing primary care practices.
Academy leaders also urged the United representatives to signify to CMS their intent to participate in the Comprehensive Primary Care Initiative, a collaboration between CMS and commercial and state health insurance plans that will support a blended payment system that will provide participating practices with fee-for-service payments and a risk-adjusted per-patient, per-month coordination fee ranging from $8 to $40.
The AAFP is planning similar meetings with other large commercial insurers for 2012, where the focus will be on payment and improving care coordination and quality.
Superior Metabolic Technologies Inc. in Marietta, Ga., is voluntarily recalling(www.fda.gov) all lots of its testosterone-boosting drug Uprizing 2.0 because it contains superdrol, a synthetic steroid that is banned by the FDA.
Synthetic anabolic steroids can have harmful side effects in men, women and children, including acute liver damage; shrinkage of the testes; male infertility; female masculinization; male breast enlargement; short stature in children; higher probability of the misuse of drugs and alcohol; effects on blood lipid levels; and increased risks for heart attack, stroke and death.
Uprizing 2.0 was sold in retail health food stores in Alabama, Arizona, California, Georgia, Mississippi, New Jersey, South Carolina and Texas. Any reactions or problems with the product should be reported to the FDA's MedWatch Adverse Event Reporting program(www.accessdata.fda.gov).
The Medicare Payment Advisory Commission, or MedPAC, has approved a final recommendation to Congress that would repeal the sustainable growth rate, or SGR, formula by freezing payment levels for primary care services during the next 10 years while cutting payment rates for subspecialty and other nonprimary care services by 5.9 percent for the next three years and then freezing them for another seven years.
MedPAC, which advises Congress on Medicare payment and other issues, also approved these recommendations:
- Congress should direct the HHS secretary to regularly collect data to establish more accurate work and practice expense values.
- Congress should direct HHS to identify overpriced fee schedule services and reduce their relative value units accordingly.
- HHS should increase shared savings opportunities for physicians and health professionals who join or lead two-sided risk accountable care organizations.
HHS has announced a series of funding initiatives for community health centers, or CHCs, and community-based organizations to support and strengthen primary care and behavioral health services throughout the country. This includes $32 million in funds to help 904 CHCs achieve medical home recognition status, according to an HHS press release(www.hhs.gov).
The CHCs will use the $32 million for activities needed to achieve medical home recognition status, including care planning, support for team-based models of service delivery, and system upgrades, HHS says. The Health Resources and Services Administration will administer the grants.
Meanwhile, the Substance Abuse and Mental Health Services Administration, or SAMHSA, is awarding $15 million in funds authorized by the Patient Protection and Affordable Care Act to promote better primary care and behavioral health services for individuals with mental and substance use disorders, according to HHS. SAMHSA is awarding the grants to CHCs and public health departments in cities throughout the country.
The American Board of Medical Specialties, or ABMS, recently approved the creation of a subspecialty certification in clinical informatics. The new subspecialty is co-sponsored by the American Board of Preventive Medicine and the American Board of Pathology, and certification in the subspecialty will be available to diplomates of all ABMS member boards.
The preventive medicine and pathology boards have begun the process of creating a certification examination in clinical informatics, but the precise timing of the first offering of that exam has not yet been determined. However, the goal is to have the inaugural board exam available in fall 2012, with the first certificates awarded early in 2013.
According to a Sept. 22 press release(www.amia.org) from the American Medical Informatics Association, "The role of the clinical informatician is to use his/her knowledge of patient care in combination with an understanding of informatics concepts, methods, and tools to
- assess information and knowledge-based needs of health care professionals and patients;
- characterize, evaluate, and refine clinical processes;
- develop, implement, and refine clinical decision support systems; and
- lead or participate in the procurement, customization, development, implementation, management, evaluation, and continuous improvement of clinical information systems, such as electronic health records and order-entry systems."