News Briefs: Week of July 26-30

This roundup includes the following news briefs:

An Analysis in Brief from the Association of American Medical Colleges compares medical students' intentions to practice in underserved areas when they matriculate with their intentions to do so when they graduate.

The study involved more than 80,000 students who graduated from medical schools between 2005 and 2009. The study found that students' intentions to serve the underserved diminishes by graduation and that the direction of change differs by racial and ethnic group.

For example, when asked if they planned to locate their practice in an underserved area, students overall who were undecided at matriculation were more likely to switch to "no" than to "yes" by graduation. But black and Hispanic/Latino students who were undecided at matriculation were more likely to switch to "yes" at graduation than were white and Asian-American students.

The Patient-Centered Primary Care Collaborative, or PCPCC, recently unveiled two new resource guides. One discusses payment reform to support the patient-centered medical home, or PCMH, and the other addresses integrating comprehensive medication management into the medical home.

The first guide, Payment Reform to Support High-Performing Practice, (28-page PDF; About PDFs) reviews the ability of various payment models currently in use to support the PCMH, as well as that of other payment reform proposals. The guide concludes that payment reform is essential to the establishment and sustained operation of the PCMH by ensuring key practice transformations take place and desired PCMH outcomes are achieved. In addition, the guide's authors point out, "A blended strategy to payment reform can help minimize the shortcomings associated with any single-method approach."

The second guide, Integrating Comprehensive Medication Management to Optimize Patient Outcomes, (24-page PDF; About PDFs) describes specific features and benefits of comprehensive medication management in the medical home. The guide contends that reaching the full potential of the PCMH requires comprehensive medication management services, and it offers a list of 10 steps to achieve this goal.

The Agency for Healthcare Research and Quality, or AHRQ, has launched a new website that provides links to articles and other information about the patient-centered medical home.

The website connects users to databases of publications and other resources on the medical home and provides access to AHRQ-funded white papers on medical home issues.

According to David Meyers, M.D., director of the Center for Primary Care, Prevention and Clinical Partnerships at AHRQ, "This site will play a key part in furthering the discussion of the adoption of the medical home model across the U.S."

The Agency for Healthcare Research and Quality, or AHRQ, has released its annual state-by-state health care quality data. Users of the "State Snapshots" resource can click on an interactive map of the United States to see state-specific health care quality information, including individual states' strengths, weaknesses and opportunities for improvement.

The just-released 2009 report has been expanded to include new data on health insurance. The data are organized by source of payment: private insurance, Medicare, Medicaid or out-of-pocket payment by the patient. States also can compare their insurance-related disparities to those of other states.

The enhanced snapshot format looks at health care quality as it relates to types of care, such as preventive, acute and chronic; settings of care, such as ambulatory, nursing home and home health care; and clinical conditions, including cancer, diabetes, heart disease and respiratory disease. The report also assesses maternal and child health.

HHS has extended the deadline for comments on its proposed rule on financial conflicts of interest in federally funded research to Aug. 19.

The department's original proposed rule would amend its regulations on the Responsibility of Applicants for Promoting Objectivity in Research for which Public Health Service Funding Is Sought and Responsible Prospective Contractors.

In its amended proposed rule, HHS seeks additional comments on how the regulations should be applied to situations when a researcher or research project transfers to another institution or when a new researcher or institution becomes involved in an ongoing project.

In a move that affirms the property rights of physicians and other health care professionals, the Wisconsin Supreme Court has ruled (68-page PDF; About PDFs) that the state cannot transfer $200 million from the Injured Patients and Families Compensation Fund to use for other purposes.

Physicians and hospitals in Wisconsin are required by law to contribute to the fund to pay for medical malpractice claims that exceed the $1 million paid by private malpractice insurance. In October 2007, the state approved a plan to transfer $200 million from the fund to balance the state budget, prompting a lawsuit by the Wisconsin Medical Society. After a county circuit court ruled against the medical society, the society appealed the decision, and the case wound up before the state Supreme Court, which reversed the lower court's ruling. The new ruling will force the state to pay back the $200 million to the fund.

According to Wisconsin AFP Executive Director Larry Pheifer, the Wisconsin AFP also voiced its strong opposition to the transfer of funds, arguing that such a move would increase medical malpractice insurance rates while limiting the state's ability to recruit and retain physicians.

Pediatrician Alan Guttmacher, M.D., has been named director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, or NICHD. Guttmacher had been the institute's acting director since December 2009.

The NICHD, which is part of the NIH, conducts and supports research on topics related to the health of children, adults, families and populations.

Guttmacher has been with the NIH since 1999, when he joined the National Human Genome Research Institute as a special assistant to the director. He later served that institute as deputy director and acting director.

Harold Varmus, M.D., a Nobel Prize winner and a former director of the NIH, has taken over as the head of the National Cancer Institute, or NCI. The NCI is one of the 27 institutes and centers that comprise the NIH. HHS Secretary Kathleen Sebelius swore Varmus in as the NCI's 14th director on July 12.

Varmus was a co-recipient of the Nobel Prize in Physiology or Medicine in 1989 for studies of the genetic basis of cancer and served as the NIH director from 1993 until the end of 1999. During his tenure, Varmus played a key role in initiating a doubling of the NIH budget over a five-year period, according to an NCI press release.

Varmus most recently served as president of Memorial Sloan-Kettering Cancer Center in New York City. He also spent 23 years as a faculty member at the University of California, San Francisco, where he worked on the replication cycles of retroviruses and hepatitis B viruses, the functions of genes implicated in cancer, and the development of mouse models of human cancer.

HHS is seeking suggestions on what information to include in a national database on comparative effectiveness research, or CER, now in development.

In an announcement in the July 19 Federal Register, HHS said it is looking for sources of information on CER to include in the inventory, ways to categorize the information, and suggestions on how to ensure its usefulness and sustainability.

Comments will be taken through Aug. 9.