CMS Launches Pilot Project to Evaluate Internet-Based Personal Health Records

The Centers for Medicare and Medicaid Services (CMS) announced a new pilot project that will provide Medicare beneficiaries in South Carolina with access to an online tool called Personal Health Records (PHRs). The records include patient-entered medical information, such as physician visits, prescriptions, and medical conditions; health plan information; and links to educational resources. It is intended to help patients track health care services and communicate better with their physicians. The project is part of the CMS' effort to encourage beneficiaries covered by traditional Medicare to use Internet-based resources. CMS Acting Administrator Kerry Weems says that the resource enables patients to become more involved in their health care. A PHR differs from an electronic health record because it is controlled by the patient, and not by the physician. Although beneficiaries can currently obtain some personalized information at http://www.mymedicare.gov, the PHR would provide additional, more comprehensive information and patient support. The pilot project was launched in April 2008 and is expected to run for one year. For additional information, visit https://www.myphrsc.com/ or the CMS Web site at http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=3094.

PCPCC Project Centers Aim to Integrate Patient-Centered Care into Payment System

The Patient-Centered Primary Care Collaborative (PCPCC) has formed four project centers that will help move the nation's health care payment system toward supporting primary care and the patient-centered medical home. They include the following: (1) Center for eHealth Information Exchange and Adoption, which will evaluate the application of information technology to enable its use among private and community practices; (2) Center for Multi-stakeholder Demonstrations, which will test and share best practices; (3) Center to Promote Public Payer Implementation, which will assist public payers as they implement programs to align with the patient-centered medical home model; and (4) Center for Health Benefit Redesign and Implementation, which will create standards and buying criteria to help guide employers and other buyers of health benefits. American Academy of Family Physicians (AAFP) President Jim King, MD, Selmer, Tenn., contends that payment is the main issue because the current system does not support the medical home model. Business and health care leaders will head each of four centers, which were unveiled at the April 16, 2008, PCPCC stakeholders meeting. For more information, visit https://www.aafp.org/news-now/professional-issues/20080514pcpcc-proj-ctrs.html or the PCPCC Web site at http://www.pcpcc.net/content/collaborative-centers.

Health Care Groups Oppose Proposed Rule That Could Jeopardize Access to Care

In a letter to the U.S. Department of Health and Human Services (HHS) Secretary Michael Leavitt, seven health care organizations urged the HHS to rescind a proposed rule that could lead to further health care shortages in underserved areas. The rule aims to improve the designation of underserved areas and to target federal resources where they are needed most by consolidating the criteria for health professional shortage areas (HPSAs) and Medically Underserved Areas (MUAs). However, an analysis by AAFP's Robert Graham Center shows that under this consolidation, 600 areas could lose HPSA status and 900 areas could lose MUA status. The rule does not specify how the plan will affect the more than 34 federal programs that depend on these designations for eligibility and funding. Dan Hawkins, National Association of Community Health Centers senior vice president for policy and programs, says the rule would be most detrimental to community health centers because they receive federal funding based on MUA status. Hawkins calls on the HHS to work with experts and stakeholders to create a new, more effective plan. For more information, visit https://www.aafp.org/news-now/government-medicine/20080522hpsasmuas.html or the HHS Web site at http://bhpr.hrsa.gov/shortage/hpsafrn022908.htm.

AAFP Foundation Partners with Diabetes Educators to Facilitate Mentor Program

Peers for Progress, an AAFP Foundation–sponsored initiative, has teamed with the American Association of Diabetes Educators (AADE) to help train persons with diabetes who volunteer to mentor others with the disease. Peers for Progress, which is funded by a five-year grant from Eli Lilly and Co. Foundation, was created in June 2007 to encourage mentorships among patients with diabetes. The mentors are trained to assist others with diabetes in better managing the emotional, social, and daily self-care demands of their disease. The organization will provide six to eight grants, ranging from $500,000 to $1 million, to fund research on how peer support affects self-management, quality of life, and long-term health outcomes. AADE President Amparo Gonza, RN, CDE, says that expanding these patients' support network encourages behavior changes and adherence to physician recommendations. For more information, visit https://www.aafp.org/news-now/health-of-the-public/20080514peers4prog.html or the Peers for Progress Web site at http://www.peersforprogress.org.

Updated Guidelines Include Medications Plus Counseling for Smoking Cessation

The U.S. Public Health Service has released updated clinical practice guidelines for treating tobacco dependence in response to evidence showing that counseling and medical therapy are beneficial for adults with tobacco dependence, especially when combined. “Treating Tobacco Use and Dependence: 2008 Update” describes tobacco dependence as a chronic condition that may need repeated interventions. The update is consistent with the patient-centered medical home model because it encourages participation from the entire health care team. The guideline includes tools and recommendations for implementing individual, group, or telephone counseling and specifies seven first-line medications with information on their clinical use. Although counseling or medication alone is effective, the guideline suggests that combining them provides the most benefit. The guideline summarizes the recent evidence for effective tobacco dependence treatment and will benefit family physicians and their patients, says Carlos Jaén, MD, PhD, family physician and vice chair of the guideline update panel. For more information, visit https://www.aafp.org/news-now/clinical-care-research/20080507tobacco-guide.html or http://www.ahrq.gov/path/tobacco.htm#clinic.

Merck's Dose Replacement Program to Help Some Patients with Cost of HPV Vaccine

Merck has launched a new program that will provide some patients with free replacement doses of Gardasil, the company's quadrivalent human papillomavirus (HPV) vaccine. Physicians who enroll in the program can offer the free doses to privately insured women 19 to 26 years of age who learn after receiving the HPV vaccine that their insurance plan does not cover it. Patients who are eligible for government-funded health coverage, such as Medicaid or the Vaccines for Children program, or who do not have insurance coverage are not eligible to receive the replacement doses. The program is not available in all states. Each participating physician may receive one replacement dose for each 10 qualifying doses purchased per calendar year; this applies to doses administered on May 16, 2008, or earlier. Merck hopes to extend the program through 2009 as it works with stakeholders to address issues with private insurance reimbursements for the vaccine. For more information, visit https://www.aafp.org/news-now/clinical-care-research/20080521merck-hpvprog.html or https://www.drp4gardasil.com/Site/Home.aspx.

U.S. Measles Outbreaks Prompt CDC to Emphasize Importance of Immunizations

In response to recent measles outbreaks, the Centers for Disease Control and Prevention (CDC) has reminded physicians about the continued need for routine immunizations against the virus. In a statement posted on its Web site, the CDC says that although the disease is no longer endemic to the United States, it can be imported from other countries. According to an article published in the May 9, 2008, issue of Morbidity and Mortality Weekly Report (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5718a5.htm), 64 cases were reported between January 1 and April 15, 2008—the highest number for this period since 2001. Fifty-four of these cases were linked to importation from other countries. For more information, visit https://www.aafp.org/news-now/clinical-care-research/20080514measles.html or the CDC Web site at http://www.cdc.gov/Features/MeaslesUpdate.

Research Shows that Older Women May Benefit from Mammography Screening

Although the U.S. Preventive Services Task Force (USP-STF) does not address age in its mammography guidelines, two new studies have found that the screening test may benefit women older than 70 years. A study published in the May 20, 2008, Journal of Clinical Oncology (http://jco.ascopubs.org/cgi/content/full/26/15/2482) found that having regular mammograms decreased the risk of late-stage breast cancer in women older than 80 years; however, only one fifth of these women received regular screening. Research presented at the European Breast Cancer Conference in April, also found that mammography is beneficial in older women, but another study presented at the conference found that mammography every three years is just as effective as annual screening in older women. Although AAFP Liaison to the USPSTF Doug Campos-Outcalt, MD, MPA, does not think these studies will affect the CDC's breast cancer screening recommendations, he expects future guidelines to address mammography in older women. For more information, visit https://www.aafp.org/news-now/clinical-care-research/20080521mammography.html.

— AFP and AAFP NEWS NOW staff