Medicaid Commission Releases Recommendations for Sustainability

The Medicaid Commission, established in 2005 to evaluate ways to modernize the Medicaid program, released its final recommendations in November. The commission was charged with submitting two reports—the first recommending options to save Medicaid $10 billion over five years, and the second making long-term recommendations to ensure the program's sustainability and address long-term care, benefit design, eligibility, and quality of care. In its final recommendations, the committee advocates the placement of beneficiaries in a coordinated system of care based on the concept of a medical home, and recommends that payments be tied to objective measures of medical outcomes. Medicaid long-term care policy should encourage community-based care, the report suggests. Individual responsibility and planning should be encouraged through tax incentives for long-term care insurance, tax deductions or credits for family members or friends providing informal care, and promotion of home equity use to maintain home living. In addition, tax credits or targeted subsidies should be provided to help uninsured persons obtain private health insurance rather than defaulting into Medicaid. The commission also advocates researching a scaled match federal funding formula, with the matching rate reduced as states include higher-income populations. Health information technology should be aggressively promoted, the commission states, with establishment of an electronic health record for all beneficiaries by 2012. To access the full report, go tohttp://www.aspe.hhs.gov/medicaid/nov06/meetingnov.shtml. For more information, visithttps://www.aafp.org/news-now/government-medicine/20061129medicaidcommission.html.

CCHIT Certification Expanded to Include Products for Some Specialties

The Certification Commission for Healthcare Information Technology (CCHIT) announced that it will expand its certification of electronic health record (EHR) products to include those designed for some medical specialties and specialized care settings. The expansion was authorized and funded by the U.S. Department of Health and Human Services (HHS). According to HHS Secretary Mark Leavitt, CCHIT will tackle two or three specialized areas in the upcoming year, with more planned for the future. Prioritization of specialties will be based on the amount of work needed for criteria development, the readiness of the specialty to participate, and the potential benefit of certification on EHR adoption within the specialty. This data will be gathered for presentation at the commission's January meeting. For more information, visithttps://www.aafp.org/news-now/practice-management/20061130cchitrole.html.

CMS Increases Payment Rate for Point-of-Care Hemoglobin Testing

In its 2007 laboratory fee schedule, the Centers for Medicare and Medicaid Services (CMS) increased the payment rate for Current Procedural Terminology code 83037 (glycosylated hemoglobin home device) to $21.06—55 percent higher than the $13.56 paid by more than one half of Medicare carriers in 2006. According to Larry Fields, M.D. (Flatwoods, Ky.), chair of the Board of the American Academy of Family Physicians (AAFP), the raise may lead to an increase in the use of the office-based point-of-care testing kit in place of laboratory testing, allowing physicians to improve their monitoring of patients with diabetes. The AAFP requested higher payments for in-office testing in July 2005, recommending a payment rate of no lower than $21.06 and suggesting that a more accurate payment would be $34.00 or higher. In continuing dialogue with CMS, the AAFP emphasized that diabetes management in the United States is inadequate, but that it could be improved by better access to A1C testing. For more information, go tohttps://www.aafp.org/news-now/practice-management/20061207a1ctesting.html.

Studies Question Use of Antibiotics for Respiratory Tract Infections

Two studies published in the Annals of Family Medicine provide new evidence that antibiotics are overprescribed for upper respiratory tract infections. Researchers in Belgium assessed data from about 300 patients visiting family physicians because of acute sore throat and found that those who hope for antibiotic treatment may actually be seeking relief from pain. The most commonly cited reasons for visiting the physician were establishment of cause, pain relief, and information on the disease course. Desire for an antibiotic ranked 11th of 13 reasons, and the desire for pain relief was a strong predictor of hopes for an antibiotic. In a separate study, researchers evaluated whether clinical signs and symptoms or radiographic findings can predict the duration of rhinosinusitis and the effectiveness of antibiotic treatment. They found that recovery time was longer in patients who felt general illness and reduced productivity, but the course of illness was not influenced by treatment with antibiotics. Typical signs and symptoms and abnormalities on radiography were not prognostic and did not indicate which patients would benefit from antibiotic treatment. For more information and to access the studies, visithttps://www.aafp.org/news-now/clinical-care-research/20061206annalsantibiotics.html.

AAP Raises Concern over Effects of Advertising on Children's Health

In a revised policy statement published in the December issue of Pediatrics, the American Academy of Pediatrics (AAP) called on pediatricians to work with parents, schools, and community groups to ban or limit school-based advertising in all forms. Exposure to advertising may contribute to childhood and adolescent obesity, poor nutrition, and cigarette and alcohol use, the AAP said. However, it suggested that media education may mitigate some of the negative effects. The statement recommends that physicians who care for children become familiar with methods used by advertisers to target children, subscribe only to magazines that do not carry tobacco or alcohol advertisements for their waiting rooms, and counsel parents to limit noneducational television viewing time to two hours per day. Other recommendations include writing letters to advertisers and calling on Congress to make policy changes. For more information and to access the statement, go tohttp://www.aap.org/advocacy/releases/dec06advertising.htm.

Family Physician Elected as New President of American Cancer Society

Richard C. Wender, M.D. (Philadelphia, Pa.), became the first primary care physician to serve as president of the American Cancer Society when he was elected during the society's annual meeting in November. Dr. Wender is a practicing family physician and AAFP member as well as alumni professor and chair of the Department of Family and Community Medicine at Jefferson Medical College in Philadelphia. He has served as chair of the American Cancer Society's Incidence and Mortality Committee for the past two years and is a member of the editorial advisory board for the society's journal. For more information, go tohttp://www.cancer.org/docroot/MED/content/MED_2_1x_New_Volunteers_Selected_to_Lead_American_Cancer_Society.asp?sitearea=MED.

STOP Meningitis Initiative Issues Free Video and Patient Recall Letter

A meningococcal disease educational video and patient recall letter have been made available to physicians and other health care professionals by the National Foundation for Infectious Diseases (NFID). The resources were developed in collaboration with leading medical and advocacy organizations—including the AAFP, the AAP, the American College of Physicians, and the American Medical Association—as part of the STOP Meningitis (Share. Teach. Outreach. Protect.) initiative. Representatives from each of the collaborating groups are featured in the video, which aims to educate health care professionals, office staff, parents, and patients about the disease and the importance of immunization. The template letter is intended to help physicians implement the CDC's adolescent meningococcal immunization recommendations. To download the resources, go to the NFID Web site athttp://www.nfid.org.