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Am Fam Physician. 2013;87(1):16

Proposed Rules to Address Various Provisions of the Affordable Care Act

The Obama administration has proposed three rules to implement several key provisions of the Patient Protection and Affordable Care Act that are scheduled to take effect in 2014. First, health insurance companies would be prohibited from denying patients coverage based on preexisting or chronic health conditions. Second, policies and standards for coverage of essential health benefits would be outlined so that patients would be able to compare health plans in the individual and small-group markets. Third, employment-based wellness programs would be implemented and expanded to promote health and control health care costs. According to Jeff Cain, MD, President of the American Academy of Family Physicians (AAFP), “One of the goals of the AAFP is to make health insurance fair for patients and fair for physicians. These rules help move that agenda forward.” For more information, visit

Survey Compares Effectiveness of Private and Public Health Information Exchanges

An annual survey on health information exchanges by eHealth Initiative shows that data exchange is increasing among both public and private health information exchanges. These exchanges facilitate the electronic movement of health care data across organizations within a state, region, community, or hospital system. The 2012 survey, which included 161 health information exchanges, raises concerns about public and private exchanges in the same state or region using different operating systems and technology platforms, which can make data sharing more difficult. The primary goal of these exchanges is to provide health care professionals with better access to patient data and to help them deliver fast, safe, and affordable care. For more information, visit

Childhood Psoriasis and Obesity Linked

According to a study published in the Archives of Dermatology, U.S. children with psoriasis are four times as likely to be overweight or obese as those without the disease. Investigators from Northwestern University evaluated 614 children five to 17 years of age in nine countries to determine the relationship between excess and central adiposity and the severity of childhood psoriasis. It is not clear whether a high body mass index (BMI) precedes the development of psoriasis in these children, or if the disease leads to an increased BMI further compounded by lifestyle choices that favor adiposity. For more information, visit

Anticompetitive Market Conditions Are Common in U.S. Health Insurance Markets

The American Medical Association has released a study showing that anticompetitive market power is widespread for each of the three most popular managed care plans in the United States (i.e., point-of-service plans, health maintenance organizations, and preferred provider organizations). Investigators analyzed commercial health market shares and market concentration levels for 385 metropolitan areas in all 50 states and the District of Columbia. There was a notable absence of health insurer competition in 70 percent of the metropolitan areas studied. These markets are considered highly concentrated, based on the 2010 Horizontal Merger Guidelines issued by the U.S. Department of Justice and Federal Trade Commission. According to the study, highly concentrated markets harm patients and physicians, as evidenced by increased premiums, watered-down benefits, and the growing profitability of insurers. To order a copy of the 2012 edition of Competition in Health Insurance: A Comprehensive Study of U.S. Markets, call 800-621-8335 (mention item number OP427112). For more information, visit

CDC Updates Vaccine Storage Toolkit

The Centers for Disease Control and Prevention (CDC) recently updated its Vaccine Storage and Handling Toolkit. In addition to recommendations on vaccine storage and handling, it provides strategies for inventory management, maintaining the cold chain, and emergency procedures for protecting vaccine inventories. For more information, visit


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Copyright © 2013 by the American Academy of Family Physicians.

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