Physicians Participate in Capitol Hill Rally to Support Medicare Payment Reform

More than 250 physicians participated in an outdoor rally on Capitol Hill to lobby against the 10.6 percent decrease in Medicare payment rates scheduled to take effect July 1. After the 30-minute rally, organized by the American Medical Association (AMA), the physicians met with their state representatives and senators. AMA's President-elect Nancy Nielsen, MD, PhD, of Buffalo, NY, urged Congress to pass the Save Medicare Act of 2008 (S.B. 2785), which would block steep payment cuts through 2009 and would give lawmakers 18 months to find a solution to the flawed payment system. One third of older patients are already struggling to find a primary care physician, says Nielsen, and the July 1 payment cuts would force many physicians to turn away new Medicare patients. The rally came on the last day of the AMA's two-day national advocacy conference. The American Academy of Family Physicians (AAFP) has also led efforts to rally support for the Save Medicare Act of 2008 and to lobby against payment cuts through its Medicare: Stop the Cut Campaign. For more information, visit https://www.aafp.org/news-now/government-medicine/20080409amarally.html, https://www.aafp.org/online/en/home/policy/federal/medicarecut.html, or the AMA Web site at http://www.ama-assn.org/ama/pub/category/18328.html#Story1.

Bill Aimed at Lowering Health Insurance Costs for Small Businesses, Self-Employed

Legislation recently introduced by Sen. Richard Durbin (D-Ill.) would allow businesses with 100 or fewer employees and the self-insured to join national or state insurance pools, which would lead to lower health insurance premiums. In addition to the implementation of insurance pools, the Small Business Health Options Program (SHOP) Act would also provide tax credits for small business owners to offset contributions for employee premiums and protect small businesses from large rate increases based on employee health status or insurance claims. Durbin contends that the number of uninsured Americans has soared to 47 million largely because of a decrease in employer-sponsored coverage. Sen. Durbin has proposed similar legislation; however, unlike his previous proposals, the current bill allows states to opt out of the national insurance pool and create their own pools. The SHOP Act has bipartisan support and has gained endorsements from key trade groups, including the Service Employees International Union, the National Federation of Independent Business, and the National Association of Realtors. For more information, visit https://www.aafp.org/news-now/government-medicine/20080409durbinbill.html.

New Medication Management Standards Proposed for Emergency Departments

A proposal by the Joint Commission, the accreditation organization for more than 15,000 health care organizations and programs, calls for hospital pharmacists to conduct retrospective reviews of medication orders in emergency departments. In a letter to the Joint Commission, AAFP Board Chair Rick Kellerman, MD, Wichita, Kan., expressed objections to the proposed standard revisions. Hospitals already have review systems, says Kellerman, and the revisions would lead to a cumbersome review process, added burdens for physicians, and increased patient wait time to see a physician. Kellerman asked the commission to reconsider its original standards, which would allow hospitals to continue to review emergency department medication administration in a way that they determine is conducive to safe and timely patient care. For more information, visit https://www.aafp.org/news-now/professional-issues/20080409pharmreview.html or the Joint Commission Web site at http://www.jointcommission.org.

Reports Reflect Modest Gain in Health Care Quality Improvement, Persistent Disparities

Two new annual reports published by the Agency for Healthcare Research and Quality (AHRQ) show that the overall rate of health care quality improvement is slowing and that disparities in health care continue. The “2007 National Healthcare Quality Report” shows that between 1994 and 2005, quality of care improved across all measures by an average of 2.3 percent per year; however, an analysis of core measures from 2000 to 2005 shows that quality improvement slowed to 1.5 percent annually. AHRQ Director Carolyn Clancy, MD, says that these findings coupled with an increase in health care spending underscore the urgency to improve the value Americans receive for their health care dollars. Although the reports show an overall slowing in quality improvement and only a 1 percent improvement rate for patient safety, there were some significant areas of advancement, such as care of patients with heart attacks, number of older patients who received potentially harmful drugs, and number of of patients who developed postsurgery complications. The 2007 National Healthcare Disparities Report shows that overall disparities in health care quality and access among racial, ethnic, and socioeconomic groups have not improved, although progress has been made in some areas. For more information, visit https://www.aafp.org/news-now/health-of-the-public/20080409ahrqreports.html or the AHRQ Web site at http://www.ahrq.gov/news/press/pr2008/qrdr07pr.htm.

CDC, Physician Organizations Recommend Expanded Influenza Vaccine Coverage

The AAFP and the American Academy of Pediatrics have joined the Centers for Disease Control and Prevention's (CDC's) Advisory Committee on Immunization Practices to recommend expanded annual influenza coverage to include children six months to 18 years of age. The provisional recommendation, which is expected to receive final CDC approval this summer, is part of a framework for expanding influenza immunizations. The framework calls for immunizations for all school-age children by no later than the 2009–2010 influenza season, immunizations for household contacts of these children by the 2010–2011 season, and universal vaccination by the 2012–2013 season. The AAFP says that the expansion is worthwhile, but physician education efforts are needed to facilitate the change. For more information, visit https://www.aafp.org/news-now/clinical-care-research/20080402newflurec.html, https://www.aafp.org/online/en/home/clinical/immunizationres/expansionofinfluenza.html, or the CDC Web site at http://www.cdc.gov/vaccines/recs/provisional/downloads/flu-3-21-08-508.pdf.

U.S. Insurers Agree to National Principles for Physician Performance Measures

Some of the largest health insurance plans in the United States, including Aetna, Cigna, UnitedHealthcare, and WellPoint, have agreed to adhere to a new patient charter endorsed by leading business, consumer, health insurance, and physician groups. The Patient Charter for Physician Performance Measurement, Reporting and Tiering Programs calls for a defined set of performance measures that are based on the best evidence and that align with national standards. The charter also addresses transparency by requiring participants to consent to an outside review of the processes and methodology they use to report physician data. The charter was launched under the Consumer-Purchaser Disclosure Project and is endorsed by the AAFP, the AMA, the American College of Physicians, the American College of Cardiology, and the American College of Surgeons. For more information, visit https://www.aafp.org/news-now/professional-issues/20080402perfcharter.html or the Consumer-Purchaser Disclosure Project Web site at http://healthcaredisclosure.org/docs/files/PatientCharter040108.pdf.

Study Examines What Attributes Patients Value Most in Primary Care Consultations

A recent study, published in the March/April issue of the Annals of Family Medicine, analyzed patient priorities in primary care consultations. The study showed that patients would pay the most for a thorough physical examination ($40.87) and a physician who knows them well ($12.18). Although patient-centered attributes scored well ($12.06 to $14.82), patients placed higher priority on technical quality and continuity of care. For more information, visit https://www.aafp.org/news-now/clinical-care-research/20080402annptcareprior.html or the Annals of Family Medicine Web site at http://www.annfammed.org/cgi/content/full/6/2/107.

CME Effort Focuses on Educating Physicians About Patient Smoking Cessation Programs

Multiple organizations, including the California Academy of Family Physicians, have joined a physician education effort designed to reduce the number of U.S. smokers. The Continuing Education Aimed at Smoking Elimination (CEASE) initiative provides educational programs, including Web-based, multimedia, and live formats. The initiative is supported by a grant from Pfizer Inc. For more information, visit https://www.aafp.org/news-now/cme-lifelong-learning/20080404cease.html or the CEASE Web site at http://www.ceasesmoking2day.com.

MED WATCH FDA Recalls Fentanyl Patches, Releases Safety Advisory for Ortho Evra

The U.S. Food and Drug Administration (FDA) has recalled several lots of fentanyl patches because of defects that could allow them to leak. The recall includes all lots of the 25 mcg per hour Duragesic patch and its generic equivalent, manufactured by the Alza Corporation, and more than one dozen lots of the patch in all strengths manufactured by Actavis. For more information, visit http://www.fda.gov/medwatch/safety/2008/safety08.htm#Fentanyl. The FDA has also updated prescribing information for the Ortho Evra contraceptive patch after the release of new data showing an increased risk of venous thromboembolism in some patients who use the patch. For more information, visit http://www.fda.gov/medwatch/safety/2008/safety08.htm#orthoevrapatch.

— AFPandAAFP NEWS NOWstaff