News in Brief: Week of Aug. 29-Sept. 2

This roundup includes the following news briefs:

More than 17 million Medicare beneficiaries have accessed free preventive services so far this year, and 1 million beneficiaries have received the new annual wellness visit, both of which were covered in the Patient Protection and Affordable Care Act. That's according to state level data released by CMS on the use of Medicare preventive services.

Meanwhile, nearly 900,000 Medicare beneficiaries who fell into the Medicare prescription drug coverage gap received prescription drug discounts, resulting in a savings of $517 for each of these beneficiaries, according to CMS data.

A large, prospective, placebo-controlled trial found that a daily 250-mg dose of azithromycin, when added to usual treatment, reduced the frequency of disease exacerbations in selected patients with COPD and improved patients' quality of life. The study appears in the Aug. 25 issue of the New England Journal of Medicine.

The yearlong study was conducted at 17 sites and involved 1,142 patients. The rate of acute exacerbations was 1.48 per patient-year in the azithromycin group, compared with 1.83 per patient-year in the placebo group, and the frequency of acute exacerbations was lower among participants who received azithromycin than among those who received placebo, regardless of the rate of exacerbations per patient-year.

Quality of life, as measured by patients' scores on the St. George's Respiratory Questionnaire and the Medical Outcomes Study 36-item Health Survey, improved among patients in the treatment group compared with those in the control group, and the overall incidence of nasopharyngeal colonization with selected respiratory pathogens decreased in those taking the study drug.

Treated patients saw an increase, however, in the incidence of colonization with organisms resistant to macrolide antibiotics, as well as a higher percentage of hearing decrements.

The Justice Department launched 903 new health care fraud prosecutions during the first eight months of fiscal year 2011, a number that already exceeds the level for the entire 2010 fiscal year, according to the Transactional Records Access Clearinghouse. At this rate, the annual total of prosecutions will reach 1,355 for the current fiscal year, an 85 percent increase from the previous fiscal year, when the number of prosecutions totaled 731.

Within the United States, the Southern District of Florida, which encompasses Miami, led the nation in activity, accounting for one out of every nine health care fraud prosecutions.

The National Center for Health Statistics has issued a data brief (8-page PDF; About PDFs) that explores survey results related to trends in employment of nurse practitioners, certified nurse midwives and physician assistants among office-based physicians.

"Nurse Practitioners, Certified Nurse Midwives and Physician Assistants in Physician Offices," relies on data from the 2009 National Ambulatory Medical Care Survey. Authors cite a forecasted decline in the supply of primary care physicians in the future and note the call for an expansion in the supply of mid-level providers as a solution to the anticipated primary care shortage.

Authors found that primary care physicians were more likely to work with each of the three mid-level groups than physicians in other specialties. Mid-level providers also were more likely to be employed in large and multispecialty group practices, by middle-aged rather than older physicians, and in practices with a higher proportion of revenue from Medicaid and a lower proportion from Medicare.

HHS has awarded $137 million to states to strengthen the nation's health care infrastructure and to provide jobs in core areas of public health. The grants, which are partly supported by the Patient Protection and Affordable Care Act, will provide tobacco cessation services and strengthen public health laboratory and immunization services. The grants also are intended to prevent health care-associated infections and provide comprehensive substance abuse prevention and treatment, according to an HHS press release.

The monies will fund key state and local public health programs supported through the CDC and the Substance Abuse and Mental Health Services Administration, according to the HHS press release. Most of the grant dollars come from the Prevention and Public Health Fund created by the Affordable Care Act. The awards include

A free report from the Center for Healthcare Quality and Payment Reform details the differences among and the pros and cons of various payment bundling options physicians will have access to in the near future.

The report, Transitioning to Accountable Care; Incremental Payment Reforms to Support Higher Quality, More Affordable Health Care, (49-page PDF; About PDFs) was written by the center's executive director Harold Miller, who also serves as president and CEO of the Network for Regional Healthcare Improvement.

Miller offers expertise on payment reforms that support accountable acute care and accountable medical home and specialty care. The report explains how physicians can set prices, manage risk, ensure quality, develop a transition strategy and obtain support from payers.