AARP Campaign Aims to Block Legislation That Would Increase Beneficiary Premiums

AARP, the nation's largest lobbying organization for seniors, has launched a multimillion-dollar campaign that would stop Congress from enacting any Medicare payment update that would lead to higher premiums for beneficiaries, possibly blocking upcoming physician payment cuts. Sen. Max Baucus, D-Mont., is reportedly working on a bill that would provide a small, temporary increase in payment rates to counteract payment cuts; however, the legislation does not protect against premium increases for beneficiaries. The Keep Medicare Fair campaign has generated more than 500,000 member e-mails, petitions, and faxes urging Congress to reject any plan that passes costs to beneficiaries. AARP Spokesperson Drew Nannis says that although fair physician payments and improved access to care are important issues to the organization, Medicare payment legislation needs to protect patients so that they can afford to see their physicians. For more information, visit https://www.aafp.org/news-now/government-medicine/20080529aarp-campaign.html or the AARP Web site at http://www.aarp.org.

System to Track Postmarketing Safety of Prescription Drugs and Medical Devices

The U.S. Department of Health and Human Services (HHS) Secretary Mike Leavitt recently announced an initiative from two government agencies that will help ensure the safety of prescription drugs and medical products. The U.S. Food and Drug Administration (FDA) is working with the Centers for Medicare and Medicaid Services on an electronic system that will allow FDA researchers to access data from more than 25 million Medicare beneficiaries. Researchers will use the Sentinel System to extract specific information from patient records in order to track adverse effects that were not reported in premarketing clinical trials. The HHS and FDA are also talking with private insurers about including their beneficiaries' data in the system. Currently, adverse effects from prescription drugs and medical devices are monitored through voluntary reports from health care professionals. The Sentinel System will instead rely on proactive surveillance. Because the system provides access to certain health information from millions of patients in real time, researchers will no longer have to wait years to see the effects of a drug, says FDA Commissioner Andrew C. von Eschenbach, MD. The system allows users to search for information from patients who use a certain drug or device, then narrow the search to focus on patients with a particular adverse effect and whether it appears to be closely related to the product. In addition to improving patient safety, the system may assist in insurance reimbursement and coverage decisions. For more information, visit https://www.aafp.org/news-now/health-of-the-public/20080530sentinel.html or the HHS Web site at http://www.hhs.gov/news/press/2008pres/05/20080522a.html.

Pilot Project Links Medical Home Model with New Physician Payment Methodology

A medical home pilot project underway in New York state is the first to include an improved physician payment system. Three high-functioning primary care practices have signed on as participants in the project, which was initiated by the Capital District Physicians' Health Plan Inc. (CDPHP), a physician-governed health insurance plan in Albany, NY. Participants will be evaluated on patient-centered care, including patient access, satisfaction, and participation; economic performance, including avoidance of unnecessary procedures, emergency department visits, and preventable hospitalizations; and medical outcomes, including effective management of chronic conditions. The project uses a physician payment methodology that is based on risk-adjusted, outcome-based bonuses instead of the current fee-for-service system. Brian Morrissey, CDPHP's vice president of strategy and development, says it was important for the plan to include reimbursements that pay physicians the right amount for the right level of care. Physicians in the pilot project will begin receiving payments under this methodology beginning in January 2009. For more information, visit https://www.aafp.org/news-now/practice-management/20080606nypilot.html.

Survey Shows That Access to Care Is Most Important Health Issue to U.S. Women

A Harris Poll survey commissioned by the American Academy of Family Physicians (AAFP) shows that better access to primary care physicians tops the list of health care issues that are important to women. The “Fixing Health Care: What Women Want” survey polled 1,270 U.S. adult women about health care issues. According to the survey, most women are the health care decision makers for themselves and their families. Nearly 60 percent of respondents said they face challenges in obtaining health care, including confusing physician communication, duplicative paperwork and tests, and, sometimes, contradictory recommendations from different health care professionals. Only 39 percent of respondents said that all of their family members shared the same primary care physician. AAFP President Jim King, MD, Selmer, Tenn., presented the survey results during a May 29, 2008, interactive press conference in Washington, DC. During the press conference, he said that the findings support the importance of the patient-centered medical home. For more information, visit https://www.aafp.org/news-now/inside-aafp/20080530harris-poll.html.

FDA Proposes Label Changes to Improve Pregnancy and Breastfeeding Information

The FDA recently proposed major label revisions for prescription drugs and biological products to help physicians make more informed prescribing decisions for women who are pregnant, breastfeeding, or of childbearing age. Proponents of an improved labeling system say that the current letter pregnancy categories lead to inaccurate and oversimplified perceptions of risk, and does not allow for the addition of updated information. The new FDA rule would replace the letter categories with three sections of detailed information. The “Fetal Risk Summary” would describe the known effects and level of risk to the fetus, the “Clinical Considerations” section would include information about the risks of the drug's use before the patient becomes pregnant, dosing information, and how to address complications; and the “Data” section would provide more in-depth information about the results of human and animal studies on the drug. Labels would also include similar sections for use in breastfeeding women. New drugs would include the updated labeling format, whereas drugs already on the market would be phased into the new format. For more information, visit https://www.aafp.org/news-now/clinical-care-research/20080611fda-label.html or the FDA Web site at http://www.fda.gov/cder/regulatory/pregnancy_labeling/default.htm.

Google Service Gives Patients Access to Web-Based Personal Health Records

Google Health, an online health information service, allows patients to create a free online account that stores their personal health information. This information may also be shared between the patient and health care professionals, pharmacists, and insurers who are signed on as a Google Health partner. Although the system currently has a limited number of partners, Google expects the network to expand. The company also plans to offer nonpartners read-only access to profiles, with the permission of the patient. Some family physicians feel that this service may have minimal immediate impact considering the lower-than-expected patient response to other high-tech projects, such as virtual office visits. For more information, visit https://www.aafp.org/news-now/practice-management/20080528google-health.html or http://www.google.com/health.

Leading Health Care Researcher Calls for a Systematic Approach to U.S. Health Care

During a recent primary care forum, Commonwealth Fund Senior Vice President Cathy Schoen, MS, contended that the U.S. health care system is more fragmented, more costly, and less efficient than other industrialized nations because the United States has not implemented a systems-based approach. Schoen suggests strengthening the primary care physician base; increasing affordable health insurance coverage; and implementing information systems, such as electronic health records. The forum, sponsored by the AAFP's Robert Graham Center, was held May 23, 2008, in Washington, DC. For more information, visit https://www.aafp.org/news-now/professional-issues/20080528schoen-forum.html.

Study Reflects Major Economic Impact of Chronic Diseases in the United States

According to a recent Milken Institute study, chronic diseases are costing the United States more than $1 trillion annually, a number that could jump to $6 trillion by 2050 if the incidence of these diseases are not reduced. “An Unhealthy America: The Economic Burden of Chronic Disease” uses data from the Agency for Healthcare Research and Quality to evaluate the economic effect of cancer, diabetes, hypertension, stroke, heart disease, pulmonary conditions, and mental illness. The data show that at least 109 million Americans have one of these conditions. Lost productivity related to chronic illness is estimated at $1.3 trillion per year, and $227 billion is spent every year on direct treatment of the illnesses. Reducing the avoidable costs associated with these conditions is critical in achieving affordable health care and continued economic growth, according to the report. The authors suggest creating incentives that reward prevention and renewing the nation's commitment to achieving a healthy body weight. For more information, visit https://www.aafp.org/news-now/health-of-the-public/20080604milken-report.html or the Milken Institute Web site at http://www.milkeninstitute.org/publications/publications.taf?function=detail&ID=38801018&cat=ResRep.

— AFP and AAFP NEWS NOW staff