Medicare Beneficiaries Advised to Review Drug Plan Changes for 2007
Medicare beneficiaries have until the end of December to change or add coverage to their health and prescription drug plans. Medicare’s annual open enrollment period began on November 15 and will end on December 31, 2006. The Department of Health and Human Services (HHS) advised that Medicare beneficiaries review their plans during this period to see how changes will affect their costs and coverage in the upcoming year and how their current plans compare with other available options. Beneficiaries do not need to take any action to keep their coverage as it is. According to a tip sheet released by HHS, the number of items on formularies in stand-alone prescription drug plans will increase by an average of 13 percent in 2007, and there will be a slight decrease in the percentage of formulary items with quantity limit restrictions. For Medicare Advantage prescription drug plans, there will be an average increase of 10 percent in the number of items on formularies and no change in quantity limit rates. Neither type of plan will see a change in the rates of prior authorization, but both will see an increase in the percentage of items that require step therapy. Resources such as the 2007 “Medicare and You” handbook and a Part D Plan Performance metrics tool that enables consumers to see how each plan is rated are available athttp://www.medicare.gov. For more information, visithttps://www.aafp.org/news-now/government-medicine/20061107partd.html.
AAFP Federal Advocacy Efforts Will Focus on Physician Payment Reform
The American Academy of Family Physicians (AAFP) will focus its federal advocacy efforts on physician payment reform when the 110th Congress convenes in January. Director of the AAFP Division of Government Relations Kevin Burke said the AAFP will work to revive reform activity that slowed before the midterm elections. Democrats, who are taking charge of the House and Senate, have promised new attention to domestic issues such as health care, and several lawmakers moving into key positions have committed to action on health issues such as physician payment (weighting the Medicare pay scale more toward primary care), health care coverage improvement, and health information technology. FamMedPAC, the AAFP’s political action committee, supported 87 incumbent lawmakers or legislative candidates in the November midterm elections; 75 of these candidates won. The AAFP hopes to be able to work with these lawmakers in order to accomplish reform. For more information, visithttps://www.aafp.org/news-now/health-care-reform/20061116paymentreform.html.
Pay-for-Performance Incentives Used by One Half of Surveyed HMOs
A study conducted by the Agency for Healthcare Research and Quality (AHRQ) found that more than one half of U.S. health maintenance organizations (HMOs) used pay-for-performance programs in their contracts with physicians and hospitals. Of 242 HMOs surveyed, 126 reported using pay-for-performance incentives in 2005. Almost 90 percent of these included incentives as part of physician compensation, and more than one third included them in contracts with hospitals. One third of programs using the incentives for physicians rewarded only the highest-rated physicians or physician groups. Pay-for-performance programs were more likely in HMOs that used primary care physicians as an entry point to subspecialist care, those that gave primary care physicians monthly payments determined by the number of patients they had in a specific plan, and those that used performance-based incentives in their own compensation. The study was published in the New England Journal of Medicine in November. For more information, visithttp://www.ahrq.gov/news/press/pr2006/p4phmopr.htm.
HHS Releases Update on Pandemic Influenza Preparedness Planning
A report released by the HHS in November details U.S. efforts to prepare for pandemic influenza. According to the report, Pandemic Planning Update III, the federal stockpile of vaccines against currently circulating virus strains, which should provide at least partial protection against new strains, is enough to treat more than 3 million people; another 5 million courses are expected in 2007. HHS is also looking into the development of a universal vaccine to provide immunity against multiple virus strains. An anticipated 26 million courses of antivirals will be in the federal stockpile by the end of 2006, with 50 million projected for 2008. In addition to state purchases, this would provide antivirals for 25 percent of the population. The national stockpile also includes 73.1 million N95 respirators and 37.4 million surgical masks. Congress passed a funding request of $2.3 billion for HHS’s Pandemic Influenza Plan in June. To download a copy of the report, go tohttp://www.pandemicflu.gov. A guide to providing mass medical care is available from the AHRQ athttp://www.ahrq.gov/research/mce.
Report Cites Falls As Leading Cause of Injury Deaths in Older Persons
According to a report in the CDC’s Morbidity and Mortality Weekly Report, falls are the leading cause of injury deaths in persons 65 and older. More than 13,700 older persons died as a result of falls in 2003, the report states—an increase of more than 55 percent from 1993. Rates of fatal falls were higher in men throughout the decade. Almost 1.8 million older persons received emergency department treatment for nonfatal injuries caused by falls in 2003; and in 2000, medical costs for falls among older adults were around $19 billion. To help prevent fall-related injury and death, the CDC has produced several posters and brochures, in English, Spanish, and Chinese, advising seniors to exercise regularly, review their medications to reduce adverse effects, have their eyes checked at least once per year, and eliminate fall hazards in their homes. To download these resources go tohttp://www.cdc.gov/ncipc/duip/fallsmaterial.htm. To access the report, go tohttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm5545a1.htm.
AAMC Launches Web Site to Encourage Minority Students into Medicine
The Association of American Medical Colleges (AAMC) has launched a new Web site as part of a campaign to encourage more minority students to pursue a career in medicine. The AAMC Web site,http://www.AspiringDocs.org, contains information and resources on key topics, as well as real-life stories from minority physicians and medical students who have overcome challenges. It also provides an online community where visitors to the site can ask questions and receive advice from the AAMC, pre-health advisers, financial aid counselors, medical students, and practicing physicians. An AAMC analysis showed that although more minority students are achieving degrees in biology, the number of these students applying to medical school in the past decade has remained the same. A more diverse physician workforce is needed to match the increasing racial and ethnic diversity nationwide, the AAMC said. For more information, visithttp://www.aamc.org/newsroom/pressrel/2006/061116.htm.
Tar Wars Program Increases Children’s Understanding of Tobacco Use
Tar Wars, a tobacco-free education program for students operated by the AAFP, increases children’s awareness of the consequences and cost of tobacco use, researchers found. Researchers evaluated the impact of the program using two 14-question tests, one taken before the Tar Wars teaching session and one a few days later. Almost 3,000 students ages nine to 13 years took the first test, and 2,766 took the second, with the average number of correct responses increasing from 9.0 to 10.2. The researchers also carried out qualitative evaluation using interviews and focus groups with students, teachers, and presenters. They found that the overall message was well received, that previously known information was reinforced through novel presentation, and that new information was learned. For more information, go tohttps://www.aafp.org/news-now/clinical-care-research/20061116tarwars.html.