Primary Care and Health Outcomes Among Older Patients with Diabetes – RWJF

February 28, 2012

As health reform expands access to insurance coverage and to health care, many are concerned that an overloaded health system will mean longer waiting times for people who need care.

Using data from the Veterans Health Administration (VA), previous researchers had found that geriatric patients who had to wait a month or more had a significant probability of being hospitalized for something that could have been prevented with high quality outpatient care.

These researchers used retrospective data in the elderly population and focused on people with diabetes. They hypothesize that longer primary care wait times would lead to less use of primary care services and poor health outcomes.

Veterans who visited VA facilities with longer primary care wait times did have significantly lower primary care utilization compared with veterans who visited VA facilities with shorter primary care wait times. For veterans age 70 or older and diagnosed with selected conditions (congestive heart failure, cardiac arrhythmias, valvular disease, peripheral vascular disease, renal failure, or obesity) longer wait times increased the risk of experiencing a poor health care outcome. However, waiting longer for care did not compromise long-term health outcomes for people with diabetes, and for those under 70 years old without the selected conditions.

via Primary Care and Health Outcomes Among Older Patients with Diabetes – RWJF.


FDA’s Draft Biosimilar Guidance: A Good First Step – Health Affairs Blog

February 28, 2012

A key component of the Patient Protection and Affordable Care Act (PPACA) of 2010 has just been released with little fanfare. One of the most significant provisions in the law gives the Food and Drug Administration (FDA) the authority to regulate biosimilars, which are attempts to replicate some of the most complex medicines known as biologics. These advanced medicines treat serious medical conditions including cancer, multiple sclerosis, and rheumatoid arthritis. Last week, the FDA provided draft guidance that will eventually lead to the introduction of biosimilars in the U.S.

To date, there are no biosimilars in the U.S. market because they were considered “too complex” to include in the 1984 Hatch-Waxman legislation, which regulates the generic drug industry in America. In recent years the European Union, Canada and several other jurisdictions have made biosimilar versions of biologic products available for sale, and the United States is currently following suit.

via FDA’s Draft Biosimilar Guidance: A Good First Step – Health Affairs Blog.


Overdiagnosis as a Flaw in Health Care – NYTimes.com

February 28, 2012

Recently, however, there have been rumblings within the medical profession that suggest that the enthusiasm for early diagnosis may be waning. Most prominent are recommendations against prostate cancer screening for healthy men and for reducing the frequency of breast and cervical cancer screening. Some experts even cautioned against the recent colonoscopy results, pointing out that the study participants were probably much healthier than the general population, which would make them less likely to die of colon cancer. In addition there is a concern about too much detection and treatment of early diabetes, a growing appreciation that autism has been too broadly defined and skepticism toward new guidelines for universal cholesterol screening of children.

via Overdiagnosis as a Flaw in Health Care – NYTimes.com.


Physician Payments Sunshine Act carries hidden costs – USATODAY.com

February 28, 2012

Supporters of the Physician Payments Sunshine Act failed to take into account how expensive “sunshine” would be. Requiring drug and medical device manufacturers to publicly report virtually every payment they make to physicians, physician groups and teaching hospitals will end up costing far more than the $224 million estimated for just the first year of compliance. The biggest cost will be the valuable, socially useful physician-industry collaborations that simply won’t occur.

via Physician Payments Sunshine Act carries hidden costs – USATODAY.com.


More Americans seek dental treatment at the ER; costs can be 10 times more than checkups – The Washington Post

February 28, 2012

More Americans are turning to the emergency room for routine dental problems — a choice that often costs 10 times more than preventive care and offers far fewer treatment options than a dentist’s office, according to an analysis of government data and dental research.

Most of those emergency visits involve trouble such as toothaches that could have been avoided with regular checkups but went untreated, in many cases because of a shortage of dentists, particularly those willing to treat Medicaid patients, the analysis said.

via More Americans seek dental treatment at the ER; costs can be 10 times more than checkups – The Washington Post.


AMA pushes IPAB repeal ahead of House panel’s vote – The Hill’s Healthwatch

February 28, 2012

The American Medical Association reiterated its support Monday for Republican-led efforts to repeal the controversial cost-cutting board created by President Obama’s healthcare law.

The House Energy and Commerce Committee’s health panel is scheduled to vote this week to repeal the Independent Payment Advisory Board (IPAB). The panel of healthcare experts would be tasked with cutting Medicare payments to doctors if spending rises faster than a certain rate.

The AMA — the largest lobbying group representing doctors — said the IPAB is the wrong way to control healthcare costs. Congress, rather than an unelected panel, should be responsible for Medicare payments, the AMA said in a letter to Rep. Joe Pitts (R-Pa.), who chairs the Energy and Commerce health subcommittee.

via AMA pushes IPAB repeal ahead of House panel’s vote – The Hill’s Healthwatch.


At-Risk Patients Gain Attention of Health Insurers – NYTimes.com

February 28, 2012

Studies have already shown that Medicare spending is concentrated on a small group of individuals who are seriously ill. But an analysis by the IMS Institute for Healthcare Informatics, the research arm of IMS Health, a health information company in Danbury, Conn., provides a rare glimpse into the medical problems of people with private health insurance who are under 65. About three-quarters of them suffer from at least one chronic condition that could spiral out of control without proper care.

via At-Risk Patients Gain Attention of Health Insurers – NYTimes.com.