Early Diagnosis Of Rheumatoid Arthritis Crucial To Positive Outcomes For Patients

Main Category: Arthritis / Rheumatology
Also Included In: Preventive Medicine;  Public Health
Article Date: 24 Nov 2010 – 1:00 PST

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Positive outcomes in rheumatoid arthritis (RA) are closely linked to early diagnosis and treatment with disease-modifying antirheumatic drugs (DMARDs). A study by researchers in the Netherlands found that patients who are assessed by rheumatologists soon after RA symptoms appear are more likely to experience less joint destruction and improved chances of DMARD-free disease remission. Details of this novel study are published in the December issue of Arthritis Rheumatism, a journal of the American College of Rheumatology.

The World Health Organization (WHO) estimates that RA affects up to 1% of the population worldwide and is associated with increased morbidity, mortality, and healthcare costs. This chronic, systemic disease is characterized by inflammation in the lining of the joints which can frequently lead to joint damage. Current medical evidence suggests that early initiation of an optimal RA treatment strategy within 12 weeks of symptom onset can prevent joint damage, improve long-term function, and increase the likelihood of achieving disease remission.

Dr. Michael van der Linden and colleagues from the Leiden University Medical Center examined 1674 early arthritis patients from the Leiden Early Arthritis Clinic cohort. Of those participants, 598 (36%) were RA patients who were diagnosed between 1993 and 2006. Researchers studied the associations among total delay to physician assessment, achievement of DMARD-free-remission, and the rate of joint damage over a six-year follow-up period. Total delay was calculated as the sum of “patient delay” (time from symptom onset until patient seeks and is assessed by a general practitioner (GP)) and “GP delay” (time lapse between seeing the GP and a referral to- and appointment with a rheumatologist).

Results showed the median patient, GP, and total delay in evaluation of early arthritis patients were 2.4, 8.0, and 13.7 weeks, respectively. “Early treatment intervention dramatically improves clinical outcomes in patients with RA,” said Dr. van der Linden. “Our study presents the first evidence that RA patients who have a delay longer than 12 weeks between first symptoms and visiting a rheumatologist have a higher rate of joint destruction and lower chance of achieving a sustained DMARD-free remission.” In 69% of RA patients, an examination by a rheumatologist took place 12 or more weeks after symptoms began, which researchers suggest contributed to a joint destruction rate that was 1.3 times higher than patients assessed prior to 12 weeks. A delay in treatment was also associated with greater risk (1.87 hazard ratio) of not achieving DMARD-free disease remission.

In a related editorial published in this month’s issue, Dr. Paul Emery, Arthritis Research UK Professor of Rheumatology and Head of Musculoskeletal Diseases at Chapel Allerton Hospital in the United Kingdom and Dr. Vivian Bykerk from Brigham and Women’s Hospital in Boston, Massachusetts point out that previous studies showed delays to care are frequent, but the study by van der Linden et al. was the first to actually document the negative impact of delayed RA treatment. “These data provide further evidence that rheumatologists have the greatest impact on patients with RA when they intervene early in the disease course,” commented Dr. Emery. He further noted strategies that may help reduce delays in care such as prescreening referrals, an introduction of a specialized rheumatology referral form for GPs to use that identify urgent referrals, or set-up of central triage clinics.

Dr. van der Linden concluded, “Our results highlight the importance of reducing the delay in assessment by a rheumatologist and further studies could test whether accelerated treatment leads to improved disease outcomes in RA.” The ACR and European League Against Rheumatism (EULAR) have set up a task force to address the issue of improving RA patient outcomes through early intervention.

Sources: Wiley – Blackwell, AlphaGalileo Foundation.






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Cigarette Smoking Increases Rheumatoid Arthritis Risk In African Americans

Main Category: Arthritis / Rheumatology
Also Included In: Smoking / Quit Smoking;  Public Health
Article Date: 24 Nov 2010 – 1:00 PST

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A new study determined that African Americans who smoke cigarettes have a higher risk of developing rheumatoid arthritis (RA). RA risk is more pronounced among individuals positive for the HLA-DRB1 shared epitope, a genetic risk factor for RA. Findings from this study the largest to date examining the impact of smoking on RA risk in an African American population are available in the December issue of Arthritis Rheumatism, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology (ACR).

RA is a chronic inflammatory disease that affects the joint lining (synovial membrane) and causes pain, swelling and redness in the joints. The ACR estimates that 1.3 million Americans are diagnosed with RA and 75% of those are women. Prior studies suggest cigarette smoking may be associated with increased risk of developing RA. A 2009 health report compiled by the Centers for Disease Control and Prevention estimate that in the African American population, 26% of men and 17% of women 18 years of age and older smoke.

“RA epidemiology has been largely understudied in the African American population,” explained Ted Mikuls, MD, MSPH, from the University of Nebraska Medical Center and lead study author. “The aim of our study was to bridge the knowledge gap by determining whether smoking contributes to RA risk in African Americans and define the extent to which this association is affected by genetic risk.”

The current study evaluated participants with RA (605) and healthy controls (255) from the Consortium for the Longitudinal Evaluations of African Americans with Early Rheumatoid Arthritis (CLEAR) I study group (RA patients with less than two years disease duration from the time of symptom onset) and the CLEAR II study group (RA patients with any disease duration). Researchers analyzed smoking status (current, former, never), cumulative smoking exposure and genetic risk factor (HLA-DRB1 shared epitope (SE)).

Results showed that patients with RA were slightly more likely to report a status of former or current smoker and less likely to be never smokers than healthy subjects. Heavy smoking (greater than 10 pack-years) was found in 54% of RA patients and in 35% of controls who ever smoked. Researchers also found that RA patients were more likely than controls to have at least one HLA-DRB1 SE-containing allele (40% versus 23%).

“We found a two-fold increase in RA risk among African Americans who were heavy smokers, and this risk increased to more than four-fold in the presence of SE alleles,” commented Dr. Mikuls. “Our results suggest that roughly one in six new cases of RA occurring in African Americans could be prevented through smoking cessation or by limiting cumulative smoking exposure to less than 10 pack-years.”

Sources: Wiley – Blackwell, AlphaGalileo Foundation.






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TreatmentTrends®: Gout Study Highlights Differences In Clinical Management Of Gout Between Primary Care Physicians And Rheumatologists

Main Category: Gout
Also Included In: Arthritis / Rheumatology;  Primary Care / General Practice
Article Date: 24 Nov 2010 – 3:00 PST

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BioTrends Research Group, Inc. is pleased to announce the recent publication of a syndicated report, TreatmentTrends®: Gout. This biannual report provides a comprehensive market overview of current and future treatment trends in gout based on a primary research study fielded among 60 primary care physicians (PCPs) and 123 rheumatologists in the U.S. The report focuses on chronic and acute therapies, perceived strengths and weaknesses of chronic therapies, barriers to broader usage, promotional activity, thought leaders in the field and the anticipated impact of a newly approved agent for chronic refractory gout — Savient Pharmaceuticals’ Krystexxa.

Although half of surveyed respondents indicated that they are relatively satisfied with current gout therapies, significant barriers to effective treatment still exist. These include the toxicity and dosing limitations associated with currently available agents, the incidence of acute gout flare attacks and resultant acute care visits, the difficulty in treating patients with renal insufficiency and the extent of switching and discontinuation among users of uric acid lowering (UAL) therapies.

The report also uncovered major differences in treatment approaches between PCPs and rheumatologists including differences in gout classification, the use of serum uric acid levels to guide treatment and the use of various medications to control uric acid levels and prevent and/or treat acute flares. Both PCPs and rheumatologists have favorable impressions of Takeda’s Uloric (febuxostat) for most attributes compared to allopurinol, although reimbursement and out of pocket cost to patients continue to be barriers for Uloric uptake.

Krystexxa (pegloticase) was approved in September 2010 by the FDA for the treatment of chronic gout in patients who are refractory to conventional therapy. As many as three-fourths of surveyed rheumatologists indicated they would be likely to prescribe Krystexxa within the first 12 months of commercial availability. The agent’s rapid onset of action, ability to resolve tophi and potency in lowering uric acid levels were cited as its most important advantages with varying degrees of uptake by physician specialty and severity of disease.

Source: BioTrends Research Group, Inc





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Covidien Collaborates With Arthritis Foundation On Patient-Education Initiatives

Main Category: Arthritis / Rheumatology
Also Included In: Bones / Orthopedics
Article Date: 24 Nov 2010 – 5:00 PST

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The Arthritis Foundation and Covidien (NYSE: COV) have joined forces to help advance awareness and support for millions of people suffering from osteoarthritis in the United States. Covidien will serve as a sponsor of the Foundation’s Let’s Move Together Movement Tracker, an educational and physical activity resource for those suffering from arthritis. The tracker provides patients with personalized, step-by-step support to reach their exercise goals and stay physically active–an important component of effective arthritis treatment.1,2

The Let’s Move Together Movement Tracker is an online tool members can use to set personal goals, benchmark their physical activity and keep motivated to stay active. Social media applications for the tracker include a widget, enabling users to display progress updates on their Arthritis Foundation community page, Facebook or MySpace pages.

“The Foundation is committed to identifying ways to cure and treat arthritis, but prevention is also central to our mission. Regular physical activity, which is encouraged by the Movement Tracker, can play a great role in prevention of the most common form of arthritis,” said Rick Bell, Managing Director of Cause Development with the Arthritis Foundation. “We are excited about working with Covidien on this important initiative.”

Launched in January 2009, the Let’s Move Together campaign is a nationwide movement designed to inspire people to move every day to prevent or treat arthritis. The campaign encourages daily physical activity for better health and participation in the Arthritis Foundation’s local Arthritis Walks–an annual event that promotes fun and fitness.

“Knee osteoarthritis affects more than 10 million Americans–many of whom live with significant pain that affects their daily function,” said Herbert Neuman, M.D., Vice President of Medical Affairs and Chief Medical Officer, Pharmaceuticals, Covidien. “Our goal, in conjunction with the Arthritis Foundation, is to provide educational and useful tools, like the Movement Tracker, to patients seeking treatment-plan support and long-term success.”

Knee OA is among the five leading causes of disability in adults.3,4 According to the Arthritis Foundation, it is a chronic condition in which joint cartilage, the smooth tissue that cushions the bone and allows easy joint movement, breaks down, leading to pain, stiffness and loss of movement in the joint.5

Mallinckrodt, a Covidien company, has introduced PENNSAID(R) (diclofenac sodium topical solution) 1.5% w/w, a topical non-steroidal anti-inflammatory drug (NSAID). PENNSAID is indicatedfor treatment of the signs and symptoms of osteoarthritis of the knee(s).For more information on PENNSAID, including Important Risk Information and boxed warning, see below.


About PENNSAID

PENNSAID (diclofenac sodium topical solution) 1.5% w/w is a NSAID in a vehicle solution containing the penetrating agent DMSO.1,2 PENNSAID was developed to help increase the effective, local delivery of pain relief to patients suffering from knee osteoarthritis, a disorder impacting an estimated 10 million patients in the United States.6 PENNSAID is the only FDA-approved topical NSAID for the treatment of the signs and symptoms of knee osteoarthritis which demonstrated statistically significant differences in all three primary efficacy endpoints: pain and physical function (WOMAC), patient overall health assessment (POHA) and patient global assessment (PGA) of knee osteoarthritis.1,2,3,7

Important Risk Information About Pennsaid

Cardiovascular Risk

-Nonsteroidal anti-inflammatory drugs (NSAIDs) may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk.

-PENNSAID is contraindicated in the perioperative setting of coronary artery bypass graft (CABG) surgery.

Gastrointestinal Risk

-NSAIDs cause an increased risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk for serious gastrointestinal events.

PENNSAID is contraindicated in patients:

– with a known hypersensitivity to diclofenac sodium or any other component of PENNSAID

– who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. Severe, rarely fatal anaphylactic-like reactions to NSAIDs have been reported in such patients.

Elevation of one or more liver tests may occur during therapy with NSAIDs. PENNSAID should be discontinued immediately if abnormal liver tests persist or worsen.

Use with caution in patients with fluid retention or heart failure. Hypertension can occur with NSAID treatment. Monitor blood pressure closely with PENNSAID treatment.

Long-term administration of NSAIDs can result in renal papillary necrosis and other renal injury. Use PENNSAID with caution in patients at greatest risk of this reaction, including the elderly, those with impaired renal function, heart failure, liver dysfunction, and those taking diuretics and ACE-inhibitors.

Should not be used in pregnant or lactating women and is not approved for use in pediatric patients.

Anaphylactoid reactions may occur in patients without prior exposure to PENNSAID. NSAIDs can cause serious skin adverse events such as exfoliative dermatitis, Stevens-Johnson Syndrome (SJS), and toxic epidermal necrolysis (TEN), which can be fatal.

The most common treatment-related adverse events in patients receiving PENNSAID were application site skin reactions including dry skin (32%), contact dermatitis characterized by skin erythema and induration (9%), contact dermatitis with vesicles (2%) and pruritus (4%). In a long term safety study, contact dermatitis occurred in 13% and contact dermatitis with vesicles in 10% of patients, generally within the first 6 months of exposure, leading to a withdrawal rate for an application site event of 14%. Other common adverse events greater than placebo include: dyspepsia (9%), abdominal pain (6%), flatulence (4%), diarrhea (4%) and nausea (4%).

Do not apply to open wounds. Protect treated knee(s) from natural or artificial sunlight. Topicals such as sunscreen and bug repellant may be applied after PENNSAID treated knee(s) are completely dry. Avoid contact of PENNSAID with eyes and mucous membranes. Wash and dry hands after use.

Concurrent use with oral NSAIDs should be avoided unless benefit outweighs risk and periodic laboratory evaluations are conducted.

PENNSAID is a registered trademark of Nuvo Research Inc.

1. Minor MA. Exercise in the treatment of osteoarthritis. Rheum Dis Clin North Am 25(2):397-415, 1999.

2. Ytterberg SR, Mahowald ML, Krug HE. Exercise for arthritis. Baillieres Clin Rheumatol 8:161-189, 1994.

3. Osteoarthritis. Centers for Disease Control and Prevention Web site. Updated February 4, 2010. Accessed April 12, 2010.

4. Guccione AA, Felson DT, Anderson JJ, et al. The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. Am J Public Health. 1994;84:351-358.

5. Arthritis Foundation. Osteoarthritis Fact Sheet. [ Last Accessed April 2010]

6. Parmet S, Lynm C, Glass RM (2003). Osteoarthritis of the knee. JAMA, 289(8), 1068.

7. Tugwell PS, Wells GA, Shainhouse J. Equivalence study of a topical diclofenac solution (PENNSAID) compared with oral diclofenac in symptomatic treatment of osteoarthritis of the knee: a randomized controlled trial. Journal of Rheumatology, 2004;31(10), 2002-12.

Source:

Covidien

Arthritis Foundation







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Feds Recover $3 Billion In Health Care Fraud And Other Settlements

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Pharma Industry / Biotech Industry;  Medical Devices / Diagnostics
Article Date: 24 Nov 2010 – 4:00 PST

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CNN: “Government lawyers have recovered a near-record $3 billion this year from health care fraud and other settlements, the Justice Department announced Monday.” Assistant Attorney General Tony West said the funds included “a record $2.5 billion in recoveries from huge health care fraud cases against giant pharmaceutical firms. Only in 2006, when the federal government recovered $3.2 billion in total settlements, had recoveries previously hit the $3 billion mark” (Frieden, 11/22).

NPR: Most of the cases against pharmaceutical companies such as Pfizer, AstraZenica and Novartis were initiated “with the help of drug company employees who blow the whistle to the federal government.” The Justice Department has used the False Claims Act, “a law from the Civil War era that helps the federal government yank back money when it’s been overcharged by contractors,” to pursue drug companies “accused of questionable marketing practices or overbilling federal insurance programs. … The law has worked so efficiently in the health care sector that the government is trying to enlist whistle-blowers in all sorts of ways. The Securities and Exchange Commission recently developed a program where corporate insiders can share in the financial rewards if they provide tips on fraud to the federal government, just as the Justice Department initiative works.” However, experts say the settlements don’t hit companies hard enough to “change the economics of fraud” (Johnson, 11/23).

The Associated Press/ABC News: Of the $3 billion recovered last fiscal year, the “government collected $1.6 billion in settlements with pharmaceutical and medical device companies in cases alleging fraud against Medicare and other federal health insurance programs. This total includes $669 million in Justice’s record settlement with Pfizer Inc., which was accused of marketing drugs for uses not approved by the Food and Drug Administration” (11/22).

The Wall Street Journal: “In tandem with the Obama administration’s focus on efforts to expand coverage for the uninsured, the Justice Department has highlighted efforts to combat fraud that siphons away government health-care spending.” Since January 2009, the department has “recovered more taxpayer dollars lost to health-care fraud than in any other two-year period,” according to West (Perez, 11/23).

NextGov: The latest estimates from the Congressional Budget Office reveal that the federal government loses millions each year due to payment errors. “In 2009 alone, the federal government made $110 billion in improper payments — that’s nearly double the amount taxpayers will end up shelling out for the massive financial bailout,” the office estimates. “One-third of improper payments can be explained by poor documentation that makes it impossible to verify whether they were accurate, and another third result from failure to confirm individuals are eligible to receive the payments in the first place. The rest boil down to simple program errors, or people duping the system. …”

“In July, President Obama signed the 2010 Improper Payments Elimination and Recovery Act, saying it would reduce waste and fraud by $50 billion by 2012. The law requires agencies to conduct recovery audits for programs that spend $1 million or more annually, review programs susceptible to significant payment errors every three years, and plan corrective actions for preventing future waste” (Aitoro, 11/22).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.

© Henry J. Kaiser Family Foundation. All rights reserved.





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Government Orders Three Medicare Advantage Plans To Stop Marketing, Enrolling New Members

Main Category: Medicare / Medicaid / SCHIP
Article Date: 24 Nov 2010 – 4:00 PST

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The Wall Street Journal / Dow Jones Newswires: “The U.S. government’s Medicare program has ordered three health insurers — Universal American Corp. (UAM), Health Net Inc. (HNT) and Arcadian Health — to stop marketing to and enrolling new members in their Medicare Advantage health and prescription-drug plans, saying the companies violated regulations. The moves come at a critical time, the midst of the 2011 Medicare open-enrollment season, when seniors choose their plans for Medicare health and drug coverage for next year. Open enrollment runs from Nov. 15 through Dec. 31. While seniors can select the traditional, government-run Medicare program, insurance companies offer government-funded Medicare Advantage plans that operate like a health maintenance organization or a preferred provider organization” (Wisenberg Brin and Kingsbury, 11/22).

Stockton (Calif.) Record: “These sanctions will remain in effect until each of the three plans demonstrates to CMS that it has corrected the related deficiencies and that those deficiencies are not likely to recur. The actions will not impact the 1 million Medicare beneficiaries enrolled in these health and drug plans” (11/23).

The Associated Press/Bloomberg Businessweek: “Health insurer Universal American Corp. said Monday federal regulators will suspend the company from enrolling new members in its Medicare Advantage plans as an open-enrollment period for the government-subsidized health coverage gets under way. The Rye Brook, N.Y., company said the suspension by the Centers for Medicare and Medicaid Services starts Dec. 5 and is tied mainly [to] agent oversight and market conduct issues. It said it was ‘working diligently’ to resolve the issues as soon as possible” (11/22).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.

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Statement By Medicare Rights Center President Joe Baker On The Rivlin-Ryan Proposal

Main Category: Medicare / Medicaid / SCHIP
Article Date: 24 Nov 2010 – 5:00 PST

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When it comes to Medicare, the Rivlin-Ryan plan has a very simple solution-make people with Medicare pay more for less coverage. In short, the proposal is an attempt to appear fiscally responsible at the expense of Medicare consumers.

The proposed long-term changes to Medicare would result in higher costs for Medicare consumers and less coverage. The proposal requires new Medicare enrollees to purchase private insurance with vouchers beginning in 2021. According to the CBO analysis, under the Rivlin-Ryan proposal, Medicare consumers will probably see a reduction in benefits or pay higher premiums for the same coverage they now receive under current law.

That is a particularly bad deal for people with Medicare, as the current Medicare benefit package is considerably less generous than that provided to most workers and their families and will likely be less generous than most of the coverage slated for arrival in 2014 under health care reform. The Rivlin-Ryan proposal will only widen a gap in coverage over time for a group of the population that has greater needs and fewer resources to meet them.

In the more immediate term, the proposal will increase out-of-pocket costs for people with Medicare, and create financial burdens on current Medicare consumers, approximately half of whom live at or below 200 percent of the poverty level. In repealing the CLASS Act, a law that promotes more affordable access to long-term care services, the proposal irresponsibly ignores the growing long-term care crisis in the United States. This action puts the major financial burden for long-term care squarely back on the shoulders of middle-class Americans who have incomes too high to qualify for Medicaid coverage but cannot afford increasingly expensive long-term care.

The proposal seems to exist in a Washington, DC vacuum-ignoring both the needs of people with Medicare who are trying to make ends meet within their own budgets, as well as the provisions of the recently enacted Affordable Care Act that save billions in Medicare outlays to help the federal budget. Rather than the nuanced approach of the Affordable Care Act, which phases in savings over time and supports patient-centered reforms that aim to increase quality and efficiency, this proposal will fundamentally change the nature and purpose of the Medicare program for the worse.

To read the Congressional Budget Office’s preliminary analysis of the Rivlin-Ryan proposal, go here.

Source:

Medicare Rights Center




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Blue Cross Blue Shield Of Michigan Faces New Lawsuits, GOP In Florida Looks To Malpractice Reform To Help Draw Doctors To Medicaid Program

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Health Insurance / Medical Insurance;  Litigation / Medical Malpractice
Article Date: 24 Nov 2010 – 6:00 PST

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The Detroit Free Press: “Blue Cross Blue Shield of Michigan is facing a wave of lawsuits across the state accusing the insurance giant of pocketing millions of dollars in hidden fees from local governments and others to administer their health care plans. The state court suits — which already have cost the Blues several million dollars in verdicts and settlements — are independent of an antitrust lawsuit filed last month in federal court by the U.S. Justice Department. Although the focus of the federal suit differs, the lawsuits all contend that Blue Cross’ business practices resulted in unfair and higher costs to others” (Anstett, 11/23).

The Palm Beach Post: “One proposal by Republican lawmakers to help reduce the $20 billion that Florida expects to pay for health care for the poor in the coming year hinges on an age-old battle between doctors and lawyers: whether doctors should be protected from medical malpractice lawsuits. While the legislature’s investigation into how to cut its Medicaid budget is still in preliminary stages, much of the discussion so far has included talk of limiting lawsuits against doctors to entice more of them into the program. Whether this would actually help lower costs or even lure more doctors into the program is unclear. Florida Medical Association director of governmental affairs Jeff Scott said Medicaid’s low reimbursement rates to doctors ‘would probably be the primary reason’ many doctors now refuse to treat Medicaid patients” (Kam, 11/22).

The Naples (Fla.) Daily News: “Heath insurance costs for Florida companies rose 6.3 percent this year, slightly lower than the 6.9 percent cost increase that companies nationwide experienced but in both cases they made benefit changes to offset even bigger jumps, according to an annual survey by Mercer consulting. The average total health benefit cost that a company incurred for each employee was $9,562 nationwide but it was $8,918 in Florida for each worker, said Matthew Snook, a Mercer principal in Tampa with the global consulting firm. The figure does not include each worker’s share of cost” (Freeman, 11/22).

The Wall Street Journal: “Colorado state regulators are putting the final touches on a fat stack of rules aimed at monitoring, recording and tracking every aspect of the booming medical-marijuana industry, from seed to sale. The regulatory system – more rigorous and comprehensive than in any other state – will likely require pot growers to place tags on every plant and train security cameras on their cultivation rooms around the clock. Cannabis dispensaries, meanwhile, will likely be required to record high-resolution video of every customer’s face and photo identification and then link that footage to a computer record of each purchase” (Simon, 11/23).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.

© Henry J. Kaiser Family Foundation. All rights reserved.





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States Focus On Medicaid Budget Challenges

Main Category: Medicare / Medicaid / SCHIP
Article Date: 22 Nov 2010 – 0:00 PST

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News outlets covered states and Medicaid.

With Medicaid Waiver, California Dives Into Health Care Reform
Nearly missed in the noise from newly elected politicians vowing to upend the Obama administrations health care reform law was a federal decision allowing California to start implementing it and improve its fiscal situation in the process. On Election Day, California got word it would receive $10 billion in federal Medicaid money to extend coverage to some 500,000 people who are currently uninsured. … The plan, which the state calls a bridge to reform, is also designed to bolster the states safety-net hospitals, as well as lower overall health care costs (Vestal, Stateline, 11/19).

Auditors Suggest Ways To Curb Medicaid Drug Costs
Legislative auditors today spelled out five possible ways to curb the state’s Medicaid prescription drug costs by up to $4.6 million a year. … Auditors said Kansas government spent $243 million in fiscal 2010 on prescription drugs, the vast majority of that through the health policy authority, which oversees the state Medicaid program and the State Employees Health Benefit Plan. Kansas Medicaid spent $166 million on prescription drugs in 2010, but the state was reimbursed for more than two-thirds of that cost by the federal government, which pays most of the cost of Medicaid (Shields, Kansas Health Institute, 11/19).

Adult Diaper Vendors Fight Competitive Bid
Right now, more than 1,400 companies bill the states Medicaid program a combined $140 million a year for incontinence products. The comptrollers office says that paring down the list of vendors to a few select partners would save Medicaid $15 million a year and reduce the fraud they say is rampant in an industry that serves 100,000 of the states Medicaid patients (Ramshaw, Texas Tribune, 11/19).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.

© Henry J. Kaiser Family Foundation. All rights reserved.



Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
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Canadians Visiting Emergency Departments For Care, Instead Of Seeing Primary Health Care Providers

Main Category: Primary Care / General Practice
Also Included In: Medicare / Medicaid / SCHIP
Article Date: 23 Nov 2010 – 0:00 PST

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Today, the Health Council of Canada released survey results from the 2010 Commonwealth Fund International Health Policy Survey. The bulletin called, How Do Canadians Rate the Health Care System? examines Canadians’ insights into the performance of their health care system.

The survey results indicate that although, Canadians’ overall view of the health care system has improved over time, they recognize the need for key improvements to the system. Over half of Canadians surveyed feel that fundamental changes are required to make the system work better.

“Canadians are saying that they want to keep Medicare. They believe the quality of medical care is excellent, but are not happy with their ability to access care in a timely and coordinated way. There are gaps that can be fixed in order to improve our current system,” said John G. Abbott, CEO, Health Council of Canada. “This message is consistent with the Romanow Commission Report that was released in 2002.”

The survey shows that of all the countries surveyed, Canada fares worst when it comes to access to care after hours – anywhere other than the emergency room. In fact, 37% of Canadians say it is very difficult to get care in the evenings, weekends, or holidays without going to the emergency department. Furthermore, in the last two years, almost half (47%) of Canadians who went to an emergency department yet have a regular doctor said they could have been treated by their regular care provider had he or she been available.

“This means that Canadians may be inappropriately using emergency departments because they do not have adequate access to their primary care giver,” says Abbott. “…which is overburdening hospitals and has an overall negative impact to health care system in Canada.”

Other areas where Canada did not fare well, compared to international counterparts were around timeliness and coordination of care. In terms of timeliness, only 45% of Canadians (well under the international average of 65%) said they were able to get an appointment on the same or next day when sick or in need of medical attention. Canada ranked the worst out of the 11 countries surveyed in this area.

Furthermore, some Canadians feel that their time had been wasted because their care was poorly organized or coordinated. For example, 12% of Canadians said their test results or medical records were not available at their medical appointment.

The survey also points out that in spite of our universal Medicare system some Canadians feel that costs are a barrier to care, particularly when it comes to prescription drugs. One in 10 respondents said they had not filled a prescription or taken medication due to cost.

The survey highlights gaps in our health care system that Canadians feel need to be resolved. Canadians need timely access to both primary care providers and specialists, to avoid overuse of emergency departments. The National Pharmaceuticals Strategy needs to be implemented to ensure that no Canadians are compelled to skip or adjust medication dose due to cost. And there must be wider adoption of electronic medical and health records to improve information sharing between physicians and specialists to ensure accurate and up-to-date test results and medical records are available. The Health Council of Canada believes that Canadians have spoken clearly, with an expectation that their concerns identified in the survey will be addressed.


Quotes

“Canadians are saying that they want to keep Medicare. They believe the quality of medical care is excellent, but are not happy with their ability to access care in a timely and coordinated way. There are gaps that can be fixed in order to improve our current system. This message is consistent with the Romanow Commission Report that was released in 2002.”

– John G. Abbott, CEO, Health Council of Canada

“This means that Canadians may be inappropriately using emergency departments because they do not have adequate access to their primary care giver…which is overburdening hospitals and has an overall negative impact to health care system in Canada.”

– John G. Abbott, CEO, Health Council of Canada

About the Survey

The 2010 Commonwealth Fund International Health Policy Survey reflects the perceptions of a random sample of about 20,000 adults across 11 countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. Participants were interviewed by telephone between March and June, 2010. This included 3,309 Canadians. The core study was funded by the Commonwealth Fund. The Health Council of Canada sponsored a portion of this study along with the Ontario Health Quality Council and the Quebec Health and Welfare Commissioner (Commissaire à la santé et au bien-être du Québec).

Source:

Health Council of Canada



Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
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