Thursday, December 13, 2018
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Some populations covered by commercial payers benefited more than others under the Comprehensive Primary Care Initiative. The multi-payer, multi-year Centers for Medicare & Medicaid Innovation project was designed to help primary care practices implement care management, care coordination, preventive care and patient engagement practices. CPCI was declared a financial wash for CMS in June. Recent analysis of private health plan data shows significant decreases in costs through care management alongside significant quality of care improvement. Those plans said physician networks liked the changes, too
. (
Health Affairs
)
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A new report by the HHS Office of Inspector General examines the rate of adverse events harming patients in long-term care hospitals. One in five Medicare patients (21 percent) in LTCHs experiences an adverse event, such as hospital-acquired infections, the report found. More than half of those patients (53 percent) experience prolonged stays because of the events. Five percent of Medicare patients in LTCHs died as a result of adverse events. The OIG asked the Agency for Healthcare Research and Quality and CMS to do more to inform LTCHs about the risk of adverse events—most of which are preventable. (
Healthcare Dive
;
OIG report
)
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Innovation & Transformation
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A study of 35,000+ patients from Massachusetts General’s neurology clinics found that a telehealth option reduced in-person visits by a third in the short term, but the pattern didn’t hold over time. Those using the telehealth option were likely to simply increase the number of total visits; in fact, total combined visits (virtual plus in-person) increased by 80 percent over 18 months. After a year, the number of in-person visits for those who also used telehealth visits was the same as those who didn’t use virtual visits at all.
(
Health Affairs
[may require log in])
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Patient-centered care curbs errors when patients are truly part of the care team. A study of pediatric hospitals that put care team “rounds” at the patient bedside—with full involvement of patients and their caregivers—resulted in 38 percent fewer harmful medical errors. The protocol involved limiting medical jargon and providing written summaries of treatment plans. Average duration of rounds increased only moderately with the new protocol (from 8.5 minutes per patient to 10.2 minutes). The study results were so positive that all seven hospitals in the studies adopted the inclusive rounding practice.
(
Boston Globe
)
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Americans spent $3.5 trillion on health care last year—an average of $10,739 per person. The 3.9 percent rate of growth was slower than overall economic growth for the same period. The slower rate of growth came mostly from less use of hospital and physician services, although prescription drug price increases also moderated overall. Analysts note that Americans are still paying more every year in premiums and out-of-pocket costs for insurance premiums and health services
. (
Benefits Pro;
Health Affairs
;
Associated Press
)
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About a third of adults under age 35 have canceled or delayed getting care because of costs, according to a poll from NPR and IBM Watson Health. The proportion of those over age 65 delaying or canceling care was much lower, with only about 8 percent saying financial concerns sometimes get in the way. Younger adults were also more likely to say they or a family member had trouble paying for a health care service within the past three months. Nearly all of those surveyed (97 percent) had some form of health coverage. (
National Public Radio
)
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Conflicted docs may have overstated milk allergies
:
A 500 percent increase in prescriptions for specialty infant formula in England may have more to do with physician research ties to the formula makers than baby allergies. An article in the
British Medical Journal
says there are real questions to answer, since formula manufacturers funded the food allergy guidelines that doctors follow to prescribe the formula.
(
BMJ
)
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Mediterranean diet earns kudos
:
A new study shows the Mediterranean diet provides better long-term health benefits, specifically reducing inflammation and improving heart health. The study followed more than 25,000 women for 12 years.
(
Kaiser Health News
)
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Generic drug “cartel” under investigation
:
More than a dozen generic drug companies are the target of a 47-state antitrust case. Company executives are accused of conspiring to fix prices for about 300 drugs so that all the companies made money if they made deals with one another to divide the revenue pie. The companies—including Mylan, Teva and Dr. Reddy’s—deny the conspiracy accusations.
(
Washington Post
)
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Pregnancy causes a host of biological changes; for example, new hormones are produced, blood volume doubles, and liver and kidney functions change. Because medical research for other health conditions excludes pregnant women (they’re deemed a “vulnerable” population for research purposes), no one knows how or if many treatments for the general population work for them. That puts pregnant women at greater risk, experts say, because doctors don’t know how to address these knowledge gaps. A new report, mandated by the 21
st
Century Cures Act, recommends more federal dollars go to research and treatments affecting pregnant and breastfeeding women (
National Public Radio
)
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MarketVoices...quotes worth reading
“That's where the irony comes in. Because researchers are hardly ever permitted to conduct trials on pregnant women, we end up experimenting on pregnant women all the time, because we can't accumulate a solid fund of evidence. So we just stick with the old standards, or we introduce new things without doing trials on them."-- Jacqueline Wolf, a professor of the history of medicine in the department of social medicine at Ohio University, as quoted by
National Public Radio.
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Sandy Mau
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