The message of antibiotic resistance isn’t getting
getting
through—at least
, not based on research published in
JAMA Internal Medicine
. Nearly 46 percent of those who visit urgent care clinics seeking treatment for conditions that don’t require antibiotics nevertheless received a prescription for one. The rate in traditional doctors’ offices was 17 percent. Interestingly, retail clinics had the lowest rate for these antibiotic-inappropriate diagnoses, at 14.4 percent. The accompanying editorial sums it up nicely: “Overprescription in Urgent Care Clinics—The Fast and the Spurious.”
(
Washington Post
;
JAMA Internal Medicine
)
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Compensation for primary care doctors has increased by more than 10 percent over the past five years, nearly twice the rate for specialty physicians, according to a survey released last week by the Medical Group Management Association. “This increase, which is nearly double that of specialty physicians’ compensation over the same period, is further evidence of the worsening primary care physician shortage in the American healthcare system,” according to the organization.
(
MGMA announcement
)
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Boosting Medicaid payment levels didn’t incentivize primary care physicians to accept more Medicaid patients, according to analysis published in
JAMA Internal Medicine
. “This finding is contrary to hypotheses informed by evidence from analyses of cross-sectional data from before the payment increase showing strong positive associations between Medicaid payment and participation rates.” However, in an accompanying commentary, Allan H. Goroll, MD, of Harvard Medical School, questioned whether an increase in fee-for-service reimbursement is an appropriate way to incentivize Medicaid participation.
(
MedPage Today
;
JAMA Internal Medicine
;
commentary
)
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Innovation & Transformation
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Last week, CMS proposed—among other things—paying doctors for virtual visits. Among the provisions of the extensive proposed rule is one to compensate physicians who contact Medicare beneficiaries via telephone or other telecommunication devices to assess whether an office visit is needed. CMS would also pay for the time it takes physicians to review patient-sent videos and images sent by a patient. “We're not intending to replace office visits but rather to augment them and create new access points for patients,” says CMS Administrator Seema Verma.
(
Modern Healthcare
)
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Physicians’ beliefs may be overriding cancer patients’ wishes for end-of-life care. Research published in
Health Affairs
reveals that the variation in the intensity of treatment stems more from the availability of services and physicians’ discomfort navigating end-of-life choices than from patients’ wishes. “Physicians in higher-spending areas reported less knowledge about and comfort with treating dying patients and less positive attitudes about hospice, compared to those in lower-spending areas.”
(
Health Affairs
;
STAT
)
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The busier an inpatient ward is, the greater risk of patient infection. Right? Wrong, according to research published in the
Journal of Hospital Medicine.
Researchers found that patients were most likely to contract
Clostridium difficile
when inpatient wards were in the “middle range” of capacity—between a quarter and three-quarters full. “What happens when we’re at our average? Do we get more complacent? Are there policies that change when they get really busy?” Mahshid Abir, MD, the study’s lead author, says in
FierceHealthcare
.
(
Journal of Hospital Medicine
;
FierceHealthcare
)
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Do you have a colleague who needs to keep up with health news and trends? Share
H2R Minutes
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Hidden admin costs:
Citing an array of research, health care economist Austin Frakt explains the
“astonishingly high”—and often hidden—administrative costs of health care. “Because they’re not directly related to patient care, we rarely think about administrative costs. They’re high.”
(
The New York Times
)
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ECRI to resurrect AHRQ clearinghouse:
The A
gency for Healthcare Research and Quality shuttered the National Guideline Clearinghouse website July 17 because of a funding cut. The same day, the non-profit ECRI Institute, which developed and maintained the NCG for two decades, announced it will launch an interim website this fall. The clearinghouse is used by doctors, insurers and health systems to find current information about best practices. Participating guideline developers will be able to access and contribute to the new site free of charge, ECRI says, but it will charge a fee for others to access the information.
(
Politico
;
ECRI announcement
)
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A big EHR update:
Genevieve Morris, currently the principal deputy ONC coordinator, will oversee the VA’s new Office of Electronic Health Record Modernization.
(
VA announcement
)
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Preventive medicine:
The Food and Drug Administration has approved the first drug intended to treat smallpox. Although the disease has been eradicated, people born after 1980 haven’t been vaccinated—and some public health officials fear the virus could be used as a biological weapon.
(
ABC News
)
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Often, health care teams react to complications, seeing them as acceptable, instead of working to prevent them. In this podcast, Ilana R. Yurkiewicz, MD, a resident at Stanford Health Care, calls on them to step up. She shares this with an essay about her father: “Complicated: Medical Missteps Are Not Inevitable.”
(
Health Affairs
podcast
)
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MarketVoices...quotes worth reading
“This is not to deny that an astronomical increase in evaluation and management valuations might have some result, but certainly not the aforementioned raising of FFS pay from an impossibly low Medicaid level to an undervalued Medicare
level.”—Allan H.
Goroll, MD, of Harvard Medical School on whether an increase in fee-for-service reimbursement is the best way to incentivize Medicaid participation, in a
JAMA Internal Medicine
commentary
.
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Editor
Sandy Mau
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