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Am Fam Physician. 2003;67(2):241-242

Number of Physicians Providing Care to Medicaid and Charity Patients Declines

According to results of a study by the Center for Studying Health System Change (HSC), the proportion of physicians providing charity care and treating Medicaid patients declined between 1997 and 2001. The study, “Mounting Pressures: Physicians Serving Medicaid Patients and the Uninsured, 1997–2001,” showed that the number of physicians providing charity care declined from 76.3 percent in 1997 to 71.5 percent in 2001, and the percentage of physicians providing treatment to Medicaid patients declined from 87.1 percent to 85.4 percent during that period. The study results also showed that physicians who do treat uninsured and Medicaid patients see very few of these types of patients. Among physicians who provided any charity care in 2001, 70.2 percent spent less than 5 percent of their total practice time on charity care. Among physicians with any Medicaid revenue in 2001, 53.1 percent derived 10 percent or less of their total practice revenue from Medicaid. Physicians also limited the number of new uninsured and Medicaid patients they accepted into their practices; in 2001, 16 percent and 20.9 percent of physicians were not accepting any new uninsured patients and Medicaid patients, respectively, compared with only 3.8 percent and 4.9 percent of physicians who were not accepting any new Medicare patients and privately insured patients, respectively. The study was based on results from HSC?s nationally representative Community Tracking Study Physician and Household Surveys, which involve about 12,000 physicians and 60,000 consumers. The complete report is available online

HHS Grants Expected to Provide Health Care Services for 195,000 Americans

The Department of Health and Human Services (HHS) Secretary Tommy G. Thompson recently announced the awarding of 42 grants totaling more than $13 million to create new health center sites and expand capacity at existing centers in 23 states. The grants, which are expected to provide health care services to an additional 195,000 Americans, include 20 New Access Points awards worth almost $8.3 million and 22 Expanded Medical Capacity grants totaling more than $4.7 million. These grants are the latest component of President Bush?s five-year plan to add or expand health care centers in 1,200 communities by 2006 and to increase the number of patients served annually from 10 million in 2001 to more than 16 million in 2006. In fiscal year 2002, HHS funded 171 new health care centers and awarded 131 grants to existing centers as part of this initiative. Health care centers deliver preventive and primary care to patients regardless of their ability to pay. Nearly one half of the patients treated at health centers have no insurance coverage, and others have inadequate coverage.

Survey Reveals Continued Trend of Decline in Illicit Drug Use by Adolescents

Results from the Monitoring the Future Survey of eighth, 10th, and 12th grade students in the United States showed declines in the use of marijuana, some club drugs, cigarettes, and alcohol from 2001 to 2002, according to HHS. This year?s study surveyed more than 43,000 students in 394 schools across the country about lifetime use, past year use, past month use, and daily use of drugs, alcohol, and cigarettes and smokeless tobacco. Marijuana use during the past year was at its lowest rate since 1995 among 10th graders and at its lowest rate since 1994 among eighth graders. Rates of LSD use were the lowest in the history of the survey among students in all three grades. Cigarette smoking continued the trend of significant decline in all groups that began after 1996. Steroid use remained stable from 2001 to 2002, and the only significant increases in drug use were crack use by 10th graders and the use of sedatives by 12th graders. The survey also studied the abuse of prescription pain relievers for the first time and found that nonmedical use of Oxycontin and Vicodin was reported in 4.0 percent and 9.6 percent of 12th graders, respectively. The Monitoring the Future Survey, conducted by the University of Michigan?s Institute for Social Research and funded by the National Institute on Drug Abuse at the National Institutes of Health, has monitored the illicit drug use and attitudes toward drugs of 12th graders since 1975, and of eighth and 10th graders since 1991. For more findings from the report, go online, and click on Monitoring the Future Study, 2002.

HHS Awards $100 Million to Help Prevent and Treat Diabetes Among Minorities

HHS Secretary Tommy G. Thompson recently announced the awarding of $100 million in grants to support programs that prevent and treat diabetes among American Indians and Alaska natives, especially among children and teenagers. The grants, which will be funded through the Indian Health Service (IHS) of the HHS, will go to 318 tribal, urban Indian, Indian organizations, and IHS health programs to assist in the prevention and treatment of diabetes, individual nutritional counseling, diabetes education and outreach activities, the use of diabetes teams to improve patient care, and community walking programs. The youth-focused efforts include obesity screenings, weight-management programs, and school-based physical activity programs. American Indians and Alaska natives are 2.6 times more likely to have diabetes than whites of similar age. “These grants support hundreds of programs to help people in Indian Country who are at risk for diabetes to take the right steps to prevent the disease?s onset and to provide needed services to those who already have diabetes,” Secretary Thompson said. A list of the grantees can be found online

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