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Global survey: U.S. seniors sicker, but more likely to have advance directive
Older Americans are sicker than their peers in 11 developed countries, but are most likely to have a chronic care plan and to have discussed health-promoting behaviors with their physicians, according to a new survey.
The telephone survey analyzed responses from 15,617 adults over age 65 in the United States, Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom. It’s almost an apples-to-apples comparison because Medicare beneficiaries are considered fully insured, and all the other countries have some form of universal health coverage, lead author Robin Osborn said in a briefing on the study published Nov. 19 in the journal Health Affairs.
“This new survey shows that there are areas, such as managing patients who have chronic illnesses and hospital discharge planning, where the U.S. does well compared to other countries,” Ms. Osborn, vice president and director of the International Health Policy and Practice Innovations program at the Commonwealth Fund, said in a statement.
The United States also performed well when it came to patient-physician communication, transitions from the hospital to home, and end-of-life planning (Health. Aff. [doi: 10.1377/hlthaff.2014.0947]).
More than two-thirds (68%) of respondents in the United States had two or more chronic conditions, compared with 56% in Canada and 33% in the United Kingdom, which was at the low end of the spectrum.
The vast majority of patients in all countries reported that they thought their physician spent enough time with them, including 86% of Americans. Eighty-one percent of American patients said their physician encouraged them to ask questions – putting them on par with patients in the United Kingdom, New Zealand, Germany, and Australia – compared with a low of 40% of patients in Norway.
Hospital discharge planning got high marks in the United States, with only 28% saying that they had any gaps in care after an inpatient stay. That compares with a high of around 70% of patients reporting problems in Sweden and Norway.
End-of-life planning was another area where it appears that the United States is doing better than other nations. Seventy-eight percent of U.S. patients said they had discussed their desires with a friend, family member, or physician, while 55% said they had a written advance directive, and 67% had a health care proxy.
By comparison, only 4% of Norwegians had an advance directive, and just 5% of French patients. Only Australia, Canada, and the United Kingdom had rates near those seen in the United States.
Care coordination was a problem in all the nations surveyed. Older Americans were most likely to say that medical records or test results weren’t available at a scheduled appointment (23%) or that tests were duplicated. Patients in all nations reported receiving conflicting information from different doctors, and that primary care physicians did not speak with specialists, and vice versa.
The cost of care was a bigger issue for Americans than for patients in other countries. One in 5 (19%) of U.S. seniors had a medical problem but did not visit a doctor or skipped a test or refilling a prescription because of the cost. New Zealand was second, with 10% saying they had foregone treatment because of cost. Just 3% of French patients had cost issues.
On Twitter @aliciaault
Older Americans are sicker than their peers in 11 developed countries, but are most likely to have a chronic care plan and to have discussed health-promoting behaviors with their physicians, according to a new survey.
The telephone survey analyzed responses from 15,617 adults over age 65 in the United States, Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom. It’s almost an apples-to-apples comparison because Medicare beneficiaries are considered fully insured, and all the other countries have some form of universal health coverage, lead author Robin Osborn said in a briefing on the study published Nov. 19 in the journal Health Affairs.
“This new survey shows that there are areas, such as managing patients who have chronic illnesses and hospital discharge planning, where the U.S. does well compared to other countries,” Ms. Osborn, vice president and director of the International Health Policy and Practice Innovations program at the Commonwealth Fund, said in a statement.
The United States also performed well when it came to patient-physician communication, transitions from the hospital to home, and end-of-life planning (Health. Aff. [doi: 10.1377/hlthaff.2014.0947]).
More than two-thirds (68%) of respondents in the United States had two or more chronic conditions, compared with 56% in Canada and 33% in the United Kingdom, which was at the low end of the spectrum.
The vast majority of patients in all countries reported that they thought their physician spent enough time with them, including 86% of Americans. Eighty-one percent of American patients said their physician encouraged them to ask questions – putting them on par with patients in the United Kingdom, New Zealand, Germany, and Australia – compared with a low of 40% of patients in Norway.
Hospital discharge planning got high marks in the United States, with only 28% saying that they had any gaps in care after an inpatient stay. That compares with a high of around 70% of patients reporting problems in Sweden and Norway.
End-of-life planning was another area where it appears that the United States is doing better than other nations. Seventy-eight percent of U.S. patients said they had discussed their desires with a friend, family member, or physician, while 55% said they had a written advance directive, and 67% had a health care proxy.
By comparison, only 4% of Norwegians had an advance directive, and just 5% of French patients. Only Australia, Canada, and the United Kingdom had rates near those seen in the United States.
Care coordination was a problem in all the nations surveyed. Older Americans were most likely to say that medical records or test results weren’t available at a scheduled appointment (23%) or that tests were duplicated. Patients in all nations reported receiving conflicting information from different doctors, and that primary care physicians did not speak with specialists, and vice versa.
The cost of care was a bigger issue for Americans than for patients in other countries. One in 5 (19%) of U.S. seniors had a medical problem but did not visit a doctor or skipped a test or refilling a prescription because of the cost. New Zealand was second, with 10% saying they had foregone treatment because of cost. Just 3% of French patients had cost issues.
On Twitter @aliciaault
Older Americans are sicker than their peers in 11 developed countries, but are most likely to have a chronic care plan and to have discussed health-promoting behaviors with their physicians, according to a new survey.
The telephone survey analyzed responses from 15,617 adults over age 65 in the United States, Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom. It’s almost an apples-to-apples comparison because Medicare beneficiaries are considered fully insured, and all the other countries have some form of universal health coverage, lead author Robin Osborn said in a briefing on the study published Nov. 19 in the journal Health Affairs.
“This new survey shows that there are areas, such as managing patients who have chronic illnesses and hospital discharge planning, where the U.S. does well compared to other countries,” Ms. Osborn, vice president and director of the International Health Policy and Practice Innovations program at the Commonwealth Fund, said in a statement.
The United States also performed well when it came to patient-physician communication, transitions from the hospital to home, and end-of-life planning (Health. Aff. [doi: 10.1377/hlthaff.2014.0947]).
More than two-thirds (68%) of respondents in the United States had two or more chronic conditions, compared with 56% in Canada and 33% in the United Kingdom, which was at the low end of the spectrum.
The vast majority of patients in all countries reported that they thought their physician spent enough time with them, including 86% of Americans. Eighty-one percent of American patients said their physician encouraged them to ask questions – putting them on par with patients in the United Kingdom, New Zealand, Germany, and Australia – compared with a low of 40% of patients in Norway.
Hospital discharge planning got high marks in the United States, with only 28% saying that they had any gaps in care after an inpatient stay. That compares with a high of around 70% of patients reporting problems in Sweden and Norway.
End-of-life planning was another area where it appears that the United States is doing better than other nations. Seventy-eight percent of U.S. patients said they had discussed their desires with a friend, family member, or physician, while 55% said they had a written advance directive, and 67% had a health care proxy.
By comparison, only 4% of Norwegians had an advance directive, and just 5% of French patients. Only Australia, Canada, and the United Kingdom had rates near those seen in the United States.
Care coordination was a problem in all the nations surveyed. Older Americans were most likely to say that medical records or test results weren’t available at a scheduled appointment (23%) or that tests were duplicated. Patients in all nations reported receiving conflicting information from different doctors, and that primary care physicians did not speak with specialists, and vice versa.
The cost of care was a bigger issue for Americans than for patients in other countries. One in 5 (19%) of U.S. seniors had a medical problem but did not visit a doctor or skipped a test or refilling a prescription because of the cost. New Zealand was second, with 10% saying they had foregone treatment because of cost. Just 3% of French patients had cost issues.
On Twitter @aliciaault
FROM HEALTH AFFAIRS
Feds try to clarify meaningful use attestation, hardship rules
WASHINGTON – Feeling confused about how to attest to meaningful use or how to claim a hardship exemption in 2014?
You’re not alone. Federal officials say they’ve gotten lots of questions and comments in the wake of allowing flexibility on the version of certified electronic health record that can be used and on hardship exemptions for a subset of meaningful users.
Elizabeth Myers, Policy and Outreach Lead for the Centers for Medicare & Medicaid Services’ Office of E-Health Standards and Services, tried to provide some clarity to what those rules mean for practicing physicians at the annual symposium of the American Medical Informatics Association.
On the first rule on certified EHRs, “all we did is delay the expiration of 2011 edition software,” Ms. Myers said.
Physicians who have used the 2011 edition all year will be attesting to the 2013 definition of meaningful use, using those specific objectives and clinical quality measures. Those using the 2014 edition will be attesting to the 2014 definition.
The rule was “pretty vague” on what was expected for those using a combination of the 2011 and 2014 editions, Ms. Myers said. “That’s not trying to be confusing or difficult, much as it may seem that way sometimes,” she said. “It’s really on purpose, because we recognize it will be different for every provider.”
The first step for any meaningful user seeking to attest is to visit the Office of the National Coordinator’s Certified Health IT Product website. Once there, enter in all the product names used. The system will determine whether you are using the 2011 or 2014 version, or a combination.
Users of the 2011 version are taken directly to the 2013 definitions and measures, and can follow through on attestation. Those using the 2014 version are taken to the 2014 definitions and measures for attestation.
Combination users are given a unique identifier. Once that’s entered, the system asks whether the user wants to use the 2013 or 2014 measures for attestation. The meaningful user is then walked through one of those two paths, Ms. Myers said.
Hospitals have until Nov. 30 to attest. Physicians and other eligible health care providers can start attesting now. They have the option of attesting all the way through end of February, Ms. Myers said.
She also sought to clear up confusion about the hardship exemptions. For first-time participants in 2014, applying for a hardship this year was necessary to avoid a penalty in 2015.
“The reopened, extended period for hardship applications ... is for those new participants who are still struggling to get their 2014 software in place,” Ms. Myers said. “If you are unable to fully implement 2014 edition software in 2014 and you have participated in the program in the past, your application for your hardship is due in 2015 to avoid the 2016 payment adjustment.”
Those hardship applications are due April 1 for hospitals and July 1 for eligible professionals, Ms. Myers said.
In terms of what can be claimed as a hardship, the reason has to be related to the functioning of the software – not that “I didn’t feel like paying for it,” or “I was on vacation,” she said. It has to be that you were unable to implement the software to fully meet meaningful use.
Be ready to document the request, but certified letters from vendors saying it was their fault aren’t necessary. “You need the documentation that demonstrates your circumstances,” she said. That means being able to show the certified software used, your approach for meeting objectives and measures, and how the system may have failed you.
“Keep those records,” Ms. Myers said.
On Twitter @aliciaault
WASHINGTON – Feeling confused about how to attest to meaningful use or how to claim a hardship exemption in 2014?
You’re not alone. Federal officials say they’ve gotten lots of questions and comments in the wake of allowing flexibility on the version of certified electronic health record that can be used and on hardship exemptions for a subset of meaningful users.
Elizabeth Myers, Policy and Outreach Lead for the Centers for Medicare & Medicaid Services’ Office of E-Health Standards and Services, tried to provide some clarity to what those rules mean for practicing physicians at the annual symposium of the American Medical Informatics Association.
On the first rule on certified EHRs, “all we did is delay the expiration of 2011 edition software,” Ms. Myers said.
Physicians who have used the 2011 edition all year will be attesting to the 2013 definition of meaningful use, using those specific objectives and clinical quality measures. Those using the 2014 edition will be attesting to the 2014 definition.
The rule was “pretty vague” on what was expected for those using a combination of the 2011 and 2014 editions, Ms. Myers said. “That’s not trying to be confusing or difficult, much as it may seem that way sometimes,” she said. “It’s really on purpose, because we recognize it will be different for every provider.”
The first step for any meaningful user seeking to attest is to visit the Office of the National Coordinator’s Certified Health IT Product website. Once there, enter in all the product names used. The system will determine whether you are using the 2011 or 2014 version, or a combination.
Users of the 2011 version are taken directly to the 2013 definitions and measures, and can follow through on attestation. Those using the 2014 version are taken to the 2014 definitions and measures for attestation.
Combination users are given a unique identifier. Once that’s entered, the system asks whether the user wants to use the 2013 or 2014 measures for attestation. The meaningful user is then walked through one of those two paths, Ms. Myers said.
Hospitals have until Nov. 30 to attest. Physicians and other eligible health care providers can start attesting now. They have the option of attesting all the way through end of February, Ms. Myers said.
She also sought to clear up confusion about the hardship exemptions. For first-time participants in 2014, applying for a hardship this year was necessary to avoid a penalty in 2015.
“The reopened, extended period for hardship applications ... is for those new participants who are still struggling to get their 2014 software in place,” Ms. Myers said. “If you are unable to fully implement 2014 edition software in 2014 and you have participated in the program in the past, your application for your hardship is due in 2015 to avoid the 2016 payment adjustment.”
Those hardship applications are due April 1 for hospitals and July 1 for eligible professionals, Ms. Myers said.
In terms of what can be claimed as a hardship, the reason has to be related to the functioning of the software – not that “I didn’t feel like paying for it,” or “I was on vacation,” she said. It has to be that you were unable to implement the software to fully meet meaningful use.
Be ready to document the request, but certified letters from vendors saying it was their fault aren’t necessary. “You need the documentation that demonstrates your circumstances,” she said. That means being able to show the certified software used, your approach for meeting objectives and measures, and how the system may have failed you.
“Keep those records,” Ms. Myers said.
On Twitter @aliciaault
WASHINGTON – Feeling confused about how to attest to meaningful use or how to claim a hardship exemption in 2014?
You’re not alone. Federal officials say they’ve gotten lots of questions and comments in the wake of allowing flexibility on the version of certified electronic health record that can be used and on hardship exemptions for a subset of meaningful users.
Elizabeth Myers, Policy and Outreach Lead for the Centers for Medicare & Medicaid Services’ Office of E-Health Standards and Services, tried to provide some clarity to what those rules mean for practicing physicians at the annual symposium of the American Medical Informatics Association.
On the first rule on certified EHRs, “all we did is delay the expiration of 2011 edition software,” Ms. Myers said.
Physicians who have used the 2011 edition all year will be attesting to the 2013 definition of meaningful use, using those specific objectives and clinical quality measures. Those using the 2014 edition will be attesting to the 2014 definition.
The rule was “pretty vague” on what was expected for those using a combination of the 2011 and 2014 editions, Ms. Myers said. “That’s not trying to be confusing or difficult, much as it may seem that way sometimes,” she said. “It’s really on purpose, because we recognize it will be different for every provider.”
The first step for any meaningful user seeking to attest is to visit the Office of the National Coordinator’s Certified Health IT Product website. Once there, enter in all the product names used. The system will determine whether you are using the 2011 or 2014 version, or a combination.
Users of the 2011 version are taken directly to the 2013 definitions and measures, and can follow through on attestation. Those using the 2014 version are taken to the 2014 definitions and measures for attestation.
Combination users are given a unique identifier. Once that’s entered, the system asks whether the user wants to use the 2013 or 2014 measures for attestation. The meaningful user is then walked through one of those two paths, Ms. Myers said.
Hospitals have until Nov. 30 to attest. Physicians and other eligible health care providers can start attesting now. They have the option of attesting all the way through end of February, Ms. Myers said.
She also sought to clear up confusion about the hardship exemptions. For first-time participants in 2014, applying for a hardship this year was necessary to avoid a penalty in 2015.
“The reopened, extended period for hardship applications ... is for those new participants who are still struggling to get their 2014 software in place,” Ms. Myers said. “If you are unable to fully implement 2014 edition software in 2014 and you have participated in the program in the past, your application for your hardship is due in 2015 to avoid the 2016 payment adjustment.”
Those hardship applications are due April 1 for hospitals and July 1 for eligible professionals, Ms. Myers said.
In terms of what can be claimed as a hardship, the reason has to be related to the functioning of the software – not that “I didn’t feel like paying for it,” or “I was on vacation,” she said. It has to be that you were unable to implement the software to fully meet meaningful use.
Be ready to document the request, but certified letters from vendors saying it was their fault aren’t necessary. “You need the documentation that demonstrates your circumstances,” she said. That means being able to show the certified software used, your approach for meeting objectives and measures, and how the system may have failed you.
“Keep those records,” Ms. Myers said.
On Twitter @aliciaault
AT THE AMIA 2014 ANNUAL SYMPOSIUM
IOM recommends social factors to include in EHRs
Electronic health records should be equipped to record and track 12 social and behavioral determinants of health, an Institute of Medicine committee recommended.
In addition to measures that are routinely collected now – race/ethnicity, tobacco use, alcohol use, and residential address – the committee advocated that electronic heath records (EHRs) should be able to capture:
• Educational attainment.
• Financial resource strain.
• Stress.
• Depression.
• Physical activity.
• Social isolation.
• Intimate partner violence (for women of reproductive age).
• Neighborhood median household income.
These measures can “provide crucial information about factors that influence health and the effectiveness of treatment,” collect data for researchers and policy makers, and help inform innovations that might improve health outcomes or reduce costs, according to the Nov. 13 report.
The panel aimed for what it called a “parsimonious panel of measures,” to help reduce the data collection burden for patients and health care providers, committee cochair Dr. William W. Stead, McKesson Foundation Professor of Biomedical Informatics and professor of medicine at Vanderbilt University, said during a press briefing.
The IOM report will be used by the Office of the National Coordinator for Health Information Technology (ONC) to determine what it should require from certified EHRs and from physicians who are participating in Medicare’s meaningful use incentive payment program. Physicians will be required to document social and behavioral determinants under Stage 3 of meaningful use, which begins in 2017.
Dr. Stead said that the speed of inclusion of the social and behavioral determinants in EHRs will partly be determined by whether the ONC follows the panel’s recommendations and requires them as part of meaningful use. He noted that in the past, EHR vendors and health care systems have been told by the ONC that they need to obtain certain types of information, “but then had to figure out on their own how to capture that information.
“There’s no reason why this needs to take years,” said Dr. Stead.
With the IOM recommendations, “we’re building the interoperability in from the beginning by providing a concise set of standard questions,” he said.
It will likely take less time to get the determinants into EHR packages than for health systems and physicians to figure out how to build the data collection into their workflow, Dr. Stead said.
The committee acknowledges that it will take more time during a patient encounter to collect these data. But, wrote the panel in the report, “the committee concluded that the health benefits of addressing these determinants outweigh the added burden to providers, patients, and health care systems.”
Additional recommendations in the report include:
• That the ONC’s EHR certification process be expanded to include appraisal of a vendor or product’s ability to acquire, store, transmit, and download self-reported data germane to the social and behavioral determinants of health.
• That the National Institutes of Health develops a plan for advancing research using social and behavioral determinants of health collected in electronic health records.
• That the Health & Human Services department convenes a task force within the next 3 years, and as needed thereafter, to review advances in the measurement of social and behavioral determinants and make recommendations for new standards and data elements for inclusion in electronic health records.
The committee’s work builds on draft recommendations published in April. It was sponsored by a number of federal agencies and health care foundations.
Dr. Michael E. Nelson, FCCP, comments: While physicians might agree that the recommendations of the Institute of Medicine (IOM) might enhance medical care, it is naïve to believe that this administrative burden will not make it increasingly difficult for physicians to meet Stage 3 of meaningful use should these requirements be added by the Office of the National Coordinator for Health Information Technology (ONC).
 |
| Dr. Michael E. Nelson |
Assuming that EHR vendors will incorporate this information into their software, the time required to elicit and record this information is not insignificant and will put further strain on the already busy clinician.
In addition, there is a major assumption that the patient will actually provide this information willingly and that there would be implied consent to allow this information to be shared with the federal government, anonymously or otherwise.
Should the ONC adopt these recommendations from the IOM, one would hope that EHR vendors are required to add this to their software at no additional cost to physicians. Also, each question might have a button for "patient declined to answer." George Orwell might have been more prescient than credited.
Dr. Nelson is affiliated with Shawnee Mission Pulmonary Consultants in Shawnee Mission, KS.
Dr. Michael E. Nelson, FCCP, comments: While physicians might agree that the recommendations of the Institute of Medicine (IOM) might enhance medical care, it is naïve to believe that this administrative burden will not make it increasingly difficult for physicians to meet Stage 3 of meaningful use should these requirements be added by the Office of the National Coordinator for Health Information Technology (ONC).
|
| Dr. Michael E. Nelson |
Assuming that EHR vendors will incorporate this information into their software, the time required to elicit and record this information is not insignificant and will put further strain on the already busy clinician.
In addition, there is a major assumption that the patient will actually provide this information willingly and that there would be implied consent to allow this information to be shared with the federal government, anonymously or otherwise.
Should the ONC adopt these recommendations from the IOM, one would hope that EHR vendors are required to add this to their software at no additional cost to physicians. Also, each question might have a button for "patient declined to answer." George Orwell might have been more prescient than credited.
Dr. Nelson is affiliated with Shawnee Mission Pulmonary Consultants in Shawnee Mission, KS.
Dr. Michael E. Nelson, FCCP, comments: While physicians might agree that the recommendations of the Institute of Medicine (IOM) might enhance medical care, it is naïve to believe that this administrative burden will not make it increasingly difficult for physicians to meet Stage 3 of meaningful use should these requirements be added by the Office of the National Coordinator for Health Information Technology (ONC).
|
| Dr. Michael E. Nelson |
Assuming that EHR vendors will incorporate this information into their software, the time required to elicit and record this information is not insignificant and will put further strain on the already busy clinician.
In addition, there is a major assumption that the patient will actually provide this information willingly and that there would be implied consent to allow this information to be shared with the federal government, anonymously or otherwise.
Should the ONC adopt these recommendations from the IOM, one would hope that EHR vendors are required to add this to their software at no additional cost to physicians. Also, each question might have a button for "patient declined to answer." George Orwell might have been more prescient than credited.
Dr. Nelson is affiliated with Shawnee Mission Pulmonary Consultants in Shawnee Mission, KS.
Electronic health records should be equipped to record and track 12 social and behavioral determinants of health, an Institute of Medicine committee recommended.
In addition to measures that are routinely collected now – race/ethnicity, tobacco use, alcohol use, and residential address – the committee advocated that electronic heath records (EHRs) should be able to capture:
• Educational attainment.
• Financial resource strain.
• Stress.
• Depression.
• Physical activity.
• Social isolation.
• Intimate partner violence (for women of reproductive age).
• Neighborhood median household income.
These measures can “provide crucial information about factors that influence health and the effectiveness of treatment,” collect data for researchers and policy makers, and help inform innovations that might improve health outcomes or reduce costs, according to the Nov. 13 report.
The panel aimed for what it called a “parsimonious panel of measures,” to help reduce the data collection burden for patients and health care providers, committee cochair Dr. William W. Stead, McKesson Foundation Professor of Biomedical Informatics and professor of medicine at Vanderbilt University, said during a press briefing.
The IOM report will be used by the Office of the National Coordinator for Health Information Technology (ONC) to determine what it should require from certified EHRs and from physicians who are participating in Medicare’s meaningful use incentive payment program. Physicians will be required to document social and behavioral determinants under Stage 3 of meaningful use, which begins in 2017.
Dr. Stead said that the speed of inclusion of the social and behavioral determinants in EHRs will partly be determined by whether the ONC follows the panel’s recommendations and requires them as part of meaningful use. He noted that in the past, EHR vendors and health care systems have been told by the ONC that they need to obtain certain types of information, “but then had to figure out on their own how to capture that information.
“There’s no reason why this needs to take years,” said Dr. Stead.
With the IOM recommendations, “we’re building the interoperability in from the beginning by providing a concise set of standard questions,” he said.
It will likely take less time to get the determinants into EHR packages than for health systems and physicians to figure out how to build the data collection into their workflow, Dr. Stead said.
The committee acknowledges that it will take more time during a patient encounter to collect these data. But, wrote the panel in the report, “the committee concluded that the health benefits of addressing these determinants outweigh the added burden to providers, patients, and health care systems.”
Additional recommendations in the report include:
• That the ONC’s EHR certification process be expanded to include appraisal of a vendor or product’s ability to acquire, store, transmit, and download self-reported data germane to the social and behavioral determinants of health.
• That the National Institutes of Health develops a plan for advancing research using social and behavioral determinants of health collected in electronic health records.
• That the Health & Human Services department convenes a task force within the next 3 years, and as needed thereafter, to review advances in the measurement of social and behavioral determinants and make recommendations for new standards and data elements for inclusion in electronic health records.
The committee’s work builds on draft recommendations published in April. It was sponsored by a number of federal agencies and health care foundations.
Electronic health records should be equipped to record and track 12 social and behavioral determinants of health, an Institute of Medicine committee recommended.
In addition to measures that are routinely collected now – race/ethnicity, tobacco use, alcohol use, and residential address – the committee advocated that electronic heath records (EHRs) should be able to capture:
• Educational attainment.
• Financial resource strain.
• Stress.
• Depression.
• Physical activity.
• Social isolation.
• Intimate partner violence (for women of reproductive age).
• Neighborhood median household income.
These measures can “provide crucial information about factors that influence health and the effectiveness of treatment,” collect data for researchers and policy makers, and help inform innovations that might improve health outcomes or reduce costs, according to the Nov. 13 report.
The panel aimed for what it called a “parsimonious panel of measures,” to help reduce the data collection burden for patients and health care providers, committee cochair Dr. William W. Stead, McKesson Foundation Professor of Biomedical Informatics and professor of medicine at Vanderbilt University, said during a press briefing.
The IOM report will be used by the Office of the National Coordinator for Health Information Technology (ONC) to determine what it should require from certified EHRs and from physicians who are participating in Medicare’s meaningful use incentive payment program. Physicians will be required to document social and behavioral determinants under Stage 3 of meaningful use, which begins in 2017.
Dr. Stead said that the speed of inclusion of the social and behavioral determinants in EHRs will partly be determined by whether the ONC follows the panel’s recommendations and requires them as part of meaningful use. He noted that in the past, EHR vendors and health care systems have been told by the ONC that they need to obtain certain types of information, “but then had to figure out on their own how to capture that information.
“There’s no reason why this needs to take years,” said Dr. Stead.
With the IOM recommendations, “we’re building the interoperability in from the beginning by providing a concise set of standard questions,” he said.
It will likely take less time to get the determinants into EHR packages than for health systems and physicians to figure out how to build the data collection into their workflow, Dr. Stead said.
The committee acknowledges that it will take more time during a patient encounter to collect these data. But, wrote the panel in the report, “the committee concluded that the health benefits of addressing these determinants outweigh the added burden to providers, patients, and health care systems.”
Additional recommendations in the report include:
• That the ONC’s EHR certification process be expanded to include appraisal of a vendor or product’s ability to acquire, store, transmit, and download self-reported data germane to the social and behavioral determinants of health.
• That the National Institutes of Health develops a plan for advancing research using social and behavioral determinants of health collected in electronic health records.
• That the Health & Human Services department convenes a task force within the next 3 years, and as needed thereafter, to review advances in the measurement of social and behavioral determinants and make recommendations for new standards and data elements for inclusion in electronic health records.
The committee’s work builds on draft recommendations published in April. It was sponsored by a number of federal agencies and health care foundations.
Medicare expanding coverage of telehealth services
Medicare will begin paying for more care delivered by telehealth next year, but restrictions could limit the growth in these virtual or remote visits.
The program pays for telehealth services only when provided in designated Health Professional Shortage Areas; additionally, patients must receive the remote care at a hospital, doctor’s office, or another approved ambulatory care site.
Physician organizations say it’s important that Medicare continues to add services that are covered when delivered via telehealth, but that greater adoption will not happen until payment and licensure issues are addressed.
According to the 2015 Medicare physician fee schedule, doctors can be paid for providing annual wellness visits, psychoanalysis, psychotherapy, and prolonged evaluation and management via telehealth.
Currently, about 10 million patients have received some form of telehealth services, according to the American Telemedicine Association. More than half (55%) of that is the remote reading of imaging by a radiologist, 24% is remote consultations, and 15% is remote monitoring. The remainder (6%) is comprised of miscellaneous and pharmacy services.
A recent survey of hospital, group practice, and home health executives found that most (84%) said that it was important or very important to develop their telehealth capability, but that reimbursement uncertainty was holding them back. Forty-one percent said they were not being reimbursed at all for telehealth, and 21% said that the rates were lower than for in-person services.
Only 6% said their programs were “mature,” according to the survey, which was conducted by Foley & Lardner, a law firm.
The American Medical Association has made expanded coverage of telehealth a priority. “We need coverage and reimbursement of telemedicine services and fewer restrictions in Medicare,” Dr. Robert Wah, the AMA president, said at the group’s interim policy meeting. “We want patients to use it if they need it. Lift geographic restrictions. Free up its use in alternative payment models.”
Telemedicine can increase access to care, especially in rural and underserved areas, according to Dr. Reid Blackwelder, board chair of the American Academy of Family Physicians. Currently, many family physicians are delivering health care remotely – by smartphone or Skype, for instance – but they often don’t get paid, he said.
Medicare requires that physicians use a G code to bill for health care provided remotely, and that additional documentation burden may mean that physicians don’t bill for it, even if they’ve delivered the care, Dr. Blackwelder said in an interview.
The AAFP would like to see a move away from those G codes, substituting a per member per month fee instead, he said.
Although Medicare pays the same amount for telehealth services as it would for the same services delivered in a face-to-face visit, not all private payers do so, which also dampens enthusiasm for telehealth, said Dr. Blackwelder.
According to the ATA, 22 states and Washington, D.C. require telehealth coverage to be on par with in-person visits.
Licensure is also an issue. Both the AAFP and the AMA support a model license plan developed by the Federation of State Medical Boards that would allow physicians to deliver services across state lines.
The Interstate Medical Licensure Compact was issued in September. According to the FSMB, 11 state medical boards have formally endorsed it: Texas, South Dakota, Wisconsin, Washington, Maine, Nevada, Alabama, Utah, Vermont, and Wyoming.
However, for licensure requirements to change, the compact must be enacted in every state.
Physician groups also want to ensure that telehealth services are given by “providers that have ongoing and established relationship with the patient,” said Dr. Blackwelder.
Medicare will begin paying for more care delivered by telehealth next year, but restrictions could limit the growth in these virtual or remote visits.
The program pays for telehealth services only when provided in designated Health Professional Shortage Areas; additionally, patients must receive the remote care at a hospital, doctor’s office, or another approved ambulatory care site.
Physician organizations say it’s important that Medicare continues to add services that are covered when delivered via telehealth, but that greater adoption will not happen until payment and licensure issues are addressed.
According to the 2015 Medicare physician fee schedule, doctors can be paid for providing annual wellness visits, psychoanalysis, psychotherapy, and prolonged evaluation and management via telehealth.
Currently, about 10 million patients have received some form of telehealth services, according to the American Telemedicine Association. More than half (55%) of that is the remote reading of imaging by a radiologist, 24% is remote consultations, and 15% is remote monitoring. The remainder (6%) is comprised of miscellaneous and pharmacy services.
A recent survey of hospital, group practice, and home health executives found that most (84%) said that it was important or very important to develop their telehealth capability, but that reimbursement uncertainty was holding them back. Forty-one percent said they were not being reimbursed at all for telehealth, and 21% said that the rates were lower than for in-person services.
Only 6% said their programs were “mature,” according to the survey, which was conducted by Foley & Lardner, a law firm.
The American Medical Association has made expanded coverage of telehealth a priority. “We need coverage and reimbursement of telemedicine services and fewer restrictions in Medicare,” Dr. Robert Wah, the AMA president, said at the group’s interim policy meeting. “We want patients to use it if they need it. Lift geographic restrictions. Free up its use in alternative payment models.”
Telemedicine can increase access to care, especially in rural and underserved areas, according to Dr. Reid Blackwelder, board chair of the American Academy of Family Physicians. Currently, many family physicians are delivering health care remotely – by smartphone or Skype, for instance – but they often don’t get paid, he said.
Medicare requires that physicians use a G code to bill for health care provided remotely, and that additional documentation burden may mean that physicians don’t bill for it, even if they’ve delivered the care, Dr. Blackwelder said in an interview.
The AAFP would like to see a move away from those G codes, substituting a per member per month fee instead, he said.
Although Medicare pays the same amount for telehealth services as it would for the same services delivered in a face-to-face visit, not all private payers do so, which also dampens enthusiasm for telehealth, said Dr. Blackwelder.
According to the ATA, 22 states and Washington, D.C. require telehealth coverage to be on par with in-person visits.
Licensure is also an issue. Both the AAFP and the AMA support a model license plan developed by the Federation of State Medical Boards that would allow physicians to deliver services across state lines.
The Interstate Medical Licensure Compact was issued in September. According to the FSMB, 11 state medical boards have formally endorsed it: Texas, South Dakota, Wisconsin, Washington, Maine, Nevada, Alabama, Utah, Vermont, and Wyoming.
However, for licensure requirements to change, the compact must be enacted in every state.
Physician groups also want to ensure that telehealth services are given by “providers that have ongoing and established relationship with the patient,” said Dr. Blackwelder.
Medicare will begin paying for more care delivered by telehealth next year, but restrictions could limit the growth in these virtual or remote visits.
The program pays for telehealth services only when provided in designated Health Professional Shortage Areas; additionally, patients must receive the remote care at a hospital, doctor’s office, or another approved ambulatory care site.
Physician organizations say it’s important that Medicare continues to add services that are covered when delivered via telehealth, but that greater adoption will not happen until payment and licensure issues are addressed.
According to the 2015 Medicare physician fee schedule, doctors can be paid for providing annual wellness visits, psychoanalysis, psychotherapy, and prolonged evaluation and management via telehealth.
Currently, about 10 million patients have received some form of telehealth services, according to the American Telemedicine Association. More than half (55%) of that is the remote reading of imaging by a radiologist, 24% is remote consultations, and 15% is remote monitoring. The remainder (6%) is comprised of miscellaneous and pharmacy services.
A recent survey of hospital, group practice, and home health executives found that most (84%) said that it was important or very important to develop their telehealth capability, but that reimbursement uncertainty was holding them back. Forty-one percent said they were not being reimbursed at all for telehealth, and 21% said that the rates were lower than for in-person services.
Only 6% said their programs were “mature,” according to the survey, which was conducted by Foley & Lardner, a law firm.
The American Medical Association has made expanded coverage of telehealth a priority. “We need coverage and reimbursement of telemedicine services and fewer restrictions in Medicare,” Dr. Robert Wah, the AMA president, said at the group’s interim policy meeting. “We want patients to use it if they need it. Lift geographic restrictions. Free up its use in alternative payment models.”
Telemedicine can increase access to care, especially in rural and underserved areas, according to Dr. Reid Blackwelder, board chair of the American Academy of Family Physicians. Currently, many family physicians are delivering health care remotely – by smartphone or Skype, for instance – but they often don’t get paid, he said.
Medicare requires that physicians use a G code to bill for health care provided remotely, and that additional documentation burden may mean that physicians don’t bill for it, even if they’ve delivered the care, Dr. Blackwelder said in an interview.
The AAFP would like to see a move away from those G codes, substituting a per member per month fee instead, he said.
Although Medicare pays the same amount for telehealth services as it would for the same services delivered in a face-to-face visit, not all private payers do so, which also dampens enthusiasm for telehealth, said Dr. Blackwelder.
According to the ATA, 22 states and Washington, D.C. require telehealth coverage to be on par with in-person visits.
Licensure is also an issue. Both the AAFP and the AMA support a model license plan developed by the Federation of State Medical Boards that would allow physicians to deliver services across state lines.
The Interstate Medical Licensure Compact was issued in September. According to the FSMB, 11 state medical boards have formally endorsed it: Texas, South Dakota, Wisconsin, Washington, Maine, Nevada, Alabama, Utah, Vermont, and Wyoming.
However, for licensure requirements to change, the compact must be enacted in every state.
Physician groups also want to ensure that telehealth services are given by “providers that have ongoing and established relationship with the patient,” said Dr. Blackwelder.
Supreme Court to hear ACA subsidy challenge
The U.S. Supreme Court has agreed to review a case challenging the legality of federal subsidies provided under the Affordable Care Act.
The Court issued the order Nov. 7, granting the plaintiffs in King v. Burwell a review of the case. The plaintiffs assert that under the ACA, only state marketplaces can issue subsidies to eligible patients.
In July, the Fourth Circuit Court of Appeals ruled against the plaintiffs, upholding the government’s ability to provide subsidies to eligible patients who purchase insurance through the 36 federally facilitated health care marketplaces.
On the same day, a limited panel of judges on the District of Columbia Circuit of the U.S. Court of Appeals ruled that the federal marketplace subsidies were not legal in a similar challenge, Halbig v. Burwell.
The government appealed, seeking a full review, which was granted in September. All 17 D.C. Circuit judges will review the case on Dec. 17.
The Supreme Court is not likely to hear King v. Burwell before that date.
On Twitter @aliciaault
The U.S. Supreme Court has agreed to review a case challenging the legality of federal subsidies provided under the Affordable Care Act.
The Court issued the order Nov. 7, granting the plaintiffs in King v. Burwell a review of the case. The plaintiffs assert that under the ACA, only state marketplaces can issue subsidies to eligible patients.
In July, the Fourth Circuit Court of Appeals ruled against the plaintiffs, upholding the government’s ability to provide subsidies to eligible patients who purchase insurance through the 36 federally facilitated health care marketplaces.
On the same day, a limited panel of judges on the District of Columbia Circuit of the U.S. Court of Appeals ruled that the federal marketplace subsidies were not legal in a similar challenge, Halbig v. Burwell.
The government appealed, seeking a full review, which was granted in September. All 17 D.C. Circuit judges will review the case on Dec. 17.
The Supreme Court is not likely to hear King v. Burwell before that date.
On Twitter @aliciaault
The U.S. Supreme Court has agreed to review a case challenging the legality of federal subsidies provided under the Affordable Care Act.
The Court issued the order Nov. 7, granting the plaintiffs in King v. Burwell a review of the case. The plaintiffs assert that under the ACA, only state marketplaces can issue subsidies to eligible patients.
In July, the Fourth Circuit Court of Appeals ruled against the plaintiffs, upholding the government’s ability to provide subsidies to eligible patients who purchase insurance through the 36 federally facilitated health care marketplaces.
On the same day, a limited panel of judges on the District of Columbia Circuit of the U.S. Court of Appeals ruled that the federal marketplace subsidies were not legal in a similar challenge, Halbig v. Burwell.
The government appealed, seeking a full review, which was granted in September. All 17 D.C. Circuit judges will review the case on Dec. 17.
The Supreme Court is not likely to hear King v. Burwell before that date.
On Twitter @aliciaault
Obama seeks emergency funding for Ebola response
President Obama has asked Congress for $6.1 billion in emergency funding to combat Ebola in West Africa and the United States.
The request comes as the World Health Organization reports that through Nov. 2, there have been a total of 13,042 confirmed, probable, and suspected cases of Ebola in eight countries (Guinea, Liberia, Mali, Nigeria, Senegal, Sierra Leone, Spain and the U.S.), and 4,818 deaths.
Although the epidemic appears to be slowing in the initially affected areas of Liberia and Sierra Leone, new cases are popping up in new regions of those countries, Health & Human Services Secretary Sylvia Burwell said during a press conference.
The emergency funding request reflects the importance of getting to those regions quickly, Ms. Burwell said. “We have to put in place the stopping of it right now, this minute.”
The administration is optimistic that Congress will grant the request, White House Office of Management and Budget Director Shaun Donovan said during the press conference. “We’ve heard a real interest in moving this, and moving it quickly.”
Specifically, the White House is seeking $4.6 billion immediately and $1.5 billion in a contingency fund that could be spent on an as-needed basis.
Included in that request is about $69 million to establish an Ebola Virus Disease Treatment Facility in each state plus Washington, New York City, Chicago, Los Angeles, and Puerto Rico. These facilities would serve as the transfer location for Ebola patients. The funds also would be used to purchase personal protective equipment (PPE), train health care workers, retrofit facilities for enhanced isolation, and create point-of-care labs in isolation areas.
The administration is also seeking $85 million to help support overall health system preparedness. The funds would be used by hospitals to buy PPE; provide training and fit-testing for hospitals, emergency medical services and ambulatory care providers; and to run drills. The money would be funneled through the federal Hospital Preparedness Program managed by 62 state and territorial departments of public health.
The Centers for Disease Control and Prevention would get about $1.8 billion of the request, the National Institutes of Health would get $230 million, and the Food and Drug Administration would get $25 million, Ms. Burwell said. Some of the CDC money would go to helping contain the epidemic in West Africa.
In the U.S., the funds for those HHS agencies would be used to help with preparedness, infection control, contact tracing, monitoring, and to developing diagnostics, vaccines, and therapeutics, she added.
Some $2 billion of the $6.1 billion overall would go to the U.S. Agency for International Development and to the State Department to help contain Ebola in West Africa.
The contingency fund would be available for any number of potential needs, Mr. Donovan said. With rapidly changing conditions, “it’s necessary to have maximum flexibility to respond quickly.”
The U.S. response is currently funded in part by the continuing resolution that is keeping the government in operation in absence of an approved federal budget. But that money runs out on Dec. 11, unless Congress acts, Mr. Donovan said. He cautioned that if that funding expires and there is no new continuing resolution or action on the emergency request, the federal government might not have any money to fight Ebola.
The request will first go through the House and Senate appropriations committees. Senate Appropriations Chairman Barbara Mikulski (D-Md.) plans to hold a hearing on the U.S. response to Ebola and the White House request on Nov. 12.
“I commend the President for acting to address this crisis at home and abroad,” Sen. Mikulski said in a statement.
On Twitter @aliciaault
President Obama has asked Congress for $6.1 billion in emergency funding to combat Ebola in West Africa and the United States.
The request comes as the World Health Organization reports that through Nov. 2, there have been a total of 13,042 confirmed, probable, and suspected cases of Ebola in eight countries (Guinea, Liberia, Mali, Nigeria, Senegal, Sierra Leone, Spain and the U.S.), and 4,818 deaths.
Although the epidemic appears to be slowing in the initially affected areas of Liberia and Sierra Leone, new cases are popping up in new regions of those countries, Health & Human Services Secretary Sylvia Burwell said during a press conference.
The emergency funding request reflects the importance of getting to those regions quickly, Ms. Burwell said. “We have to put in place the stopping of it right now, this minute.”
The administration is optimistic that Congress will grant the request, White House Office of Management and Budget Director Shaun Donovan said during the press conference. “We’ve heard a real interest in moving this, and moving it quickly.”
Specifically, the White House is seeking $4.6 billion immediately and $1.5 billion in a contingency fund that could be spent on an as-needed basis.
Included in that request is about $69 million to establish an Ebola Virus Disease Treatment Facility in each state plus Washington, New York City, Chicago, Los Angeles, and Puerto Rico. These facilities would serve as the transfer location for Ebola patients. The funds also would be used to purchase personal protective equipment (PPE), train health care workers, retrofit facilities for enhanced isolation, and create point-of-care labs in isolation areas.
The administration is also seeking $85 million to help support overall health system preparedness. The funds would be used by hospitals to buy PPE; provide training and fit-testing for hospitals, emergency medical services and ambulatory care providers; and to run drills. The money would be funneled through the federal Hospital Preparedness Program managed by 62 state and territorial departments of public health.
The Centers for Disease Control and Prevention would get about $1.8 billion of the request, the National Institutes of Health would get $230 million, and the Food and Drug Administration would get $25 million, Ms. Burwell said. Some of the CDC money would go to helping contain the epidemic in West Africa.
In the U.S., the funds for those HHS agencies would be used to help with preparedness, infection control, contact tracing, monitoring, and to developing diagnostics, vaccines, and therapeutics, she added.
Some $2 billion of the $6.1 billion overall would go to the U.S. Agency for International Development and to the State Department to help contain Ebola in West Africa.
The contingency fund would be available for any number of potential needs, Mr. Donovan said. With rapidly changing conditions, “it’s necessary to have maximum flexibility to respond quickly.”
The U.S. response is currently funded in part by the continuing resolution that is keeping the government in operation in absence of an approved federal budget. But that money runs out on Dec. 11, unless Congress acts, Mr. Donovan said. He cautioned that if that funding expires and there is no new continuing resolution or action on the emergency request, the federal government might not have any money to fight Ebola.
The request will first go through the House and Senate appropriations committees. Senate Appropriations Chairman Barbara Mikulski (D-Md.) plans to hold a hearing on the U.S. response to Ebola and the White House request on Nov. 12.
“I commend the President for acting to address this crisis at home and abroad,” Sen. Mikulski said in a statement.
On Twitter @aliciaault
President Obama has asked Congress for $6.1 billion in emergency funding to combat Ebola in West Africa and the United States.
The request comes as the World Health Organization reports that through Nov. 2, there have been a total of 13,042 confirmed, probable, and suspected cases of Ebola in eight countries (Guinea, Liberia, Mali, Nigeria, Senegal, Sierra Leone, Spain and the U.S.), and 4,818 deaths.
Although the epidemic appears to be slowing in the initially affected areas of Liberia and Sierra Leone, new cases are popping up in new regions of those countries, Health & Human Services Secretary Sylvia Burwell said during a press conference.
The emergency funding request reflects the importance of getting to those regions quickly, Ms. Burwell said. “We have to put in place the stopping of it right now, this minute.”
The administration is optimistic that Congress will grant the request, White House Office of Management and Budget Director Shaun Donovan said during the press conference. “We’ve heard a real interest in moving this, and moving it quickly.”
Specifically, the White House is seeking $4.6 billion immediately and $1.5 billion in a contingency fund that could be spent on an as-needed basis.
Included in that request is about $69 million to establish an Ebola Virus Disease Treatment Facility in each state plus Washington, New York City, Chicago, Los Angeles, and Puerto Rico. These facilities would serve as the transfer location for Ebola patients. The funds also would be used to purchase personal protective equipment (PPE), train health care workers, retrofit facilities for enhanced isolation, and create point-of-care labs in isolation areas.
The administration is also seeking $85 million to help support overall health system preparedness. The funds would be used by hospitals to buy PPE; provide training and fit-testing for hospitals, emergency medical services and ambulatory care providers; and to run drills. The money would be funneled through the federal Hospital Preparedness Program managed by 62 state and territorial departments of public health.
The Centers for Disease Control and Prevention would get about $1.8 billion of the request, the National Institutes of Health would get $230 million, and the Food and Drug Administration would get $25 million, Ms. Burwell said. Some of the CDC money would go to helping contain the epidemic in West Africa.
In the U.S., the funds for those HHS agencies would be used to help with preparedness, infection control, contact tracing, monitoring, and to developing diagnostics, vaccines, and therapeutics, she added.
Some $2 billion of the $6.1 billion overall would go to the U.S. Agency for International Development and to the State Department to help contain Ebola in West Africa.
The contingency fund would be available for any number of potential needs, Mr. Donovan said. With rapidly changing conditions, “it’s necessary to have maximum flexibility to respond quickly.”
The U.S. response is currently funded in part by the continuing resolution that is keeping the government in operation in absence of an approved federal budget. But that money runs out on Dec. 11, unless Congress acts, Mr. Donovan said. He cautioned that if that funding expires and there is no new continuing resolution or action on the emergency request, the federal government might not have any money to fight Ebola.
The request will first go through the House and Senate appropriations committees. Senate Appropriations Chairman Barbara Mikulski (D-Md.) plans to hold a hearing on the U.S. response to Ebola and the White House request on Nov. 12.
“I commend the President for acting to address this crisis at home and abroad,” Sen. Mikulski said in a statement.
On Twitter @aliciaault
ACC project seeks to reduce heart failure, MI readmissions
A program that’s designed to help hospitals reduce readmissions after inpatient treatment for a heart attack or heart failure is being launched in 35 selected hospitals.
The Patient Navigator Program is sponsored by the American College of Cardiology and AstraZeneca, which provided $10 million in funding for the 2-year pilot program, but was not involved in selection of facilities or any other aspect.
It’s “a unique collaboration between the cardiovascular care team, patients, and families to manage the stress of hospitalization for complex conditions in a way that allows patients to return home, remain healthy, and avoid the need for readmission whenever possible,” said ACC President Patrick T. O’Gara, in a statement.
Hospitals have been under pressure to reduce readmissions since the fall of 2012. That’s when Medicare began penalizing facilities up to 1% of their inpatient admissions for excess readmissions within 30 days of patients with acute myocardial infarctions, heart failure, and pneumonia. The penalty increased to 2% in fiscal year 2014, and went up to 3% in the fiscal year that started Oct. 1. For this year, chronic obstructive pulmonary disease and hip/knee arthroplasty were added to the list of conditions being monitored for readmissions.
The penalties have already been assessed for fiscal year 2015.
Medicare’s Readmissions Reduction Program bases penalties on a prior 3-year period. Fiscal 2015 penalties were based on readmissions from 2010 to 2013.
The Medicare penalties were the driving force behind the creation of the program a few years ago, said Dr. Mary Norine Walsh, chair of the ACC’s Care Transition Oversight Program. But it also represented a chance “to pursue excellence,” said Dr. Walsh in an interview.
The 35 hospitals that are participating were selected by ACC senior staff and cardiologists like Dr. Walsh who are involved in the ACC’s quality improvement efforts. To be eligible, they had to be participants in the ACC’s National Cardiovascular Data Registry ACTION Registry–GWTG, which, according to the ACC, “is a risk-adjusted, outcomes-based quality improvement program that focuses exclusively on high-risk STEMI/NSTEMI myocardial infarction patients.” The registry helps hospitals apply ACC and American Heart Association clinical guideline recommendations and provides quality improvement tools.
They also had to be part of the ACC’s Hospital to Home Initiative, which helps hospitals and cardiovascular care providers improve transitions from hospital to homes.
All 35 hospitals are eligible to receive $80,000 a year for 2 years. Most likely, the facilities will use that money to hire an individual or individuals who can act as a navigator for heart failure and MI patients, said Dr. Walsh, who is the medical director of the heart failure and cardiac transplant program at St. Vincent Heart Center, Indianapolis, Ind.
While there are few randomized, controlled trials that examine what works to reduce readmission rates, there are several interventions that have been shown to help, she said. Patient eduction and getting patients in for follow-up care within 7 days are two key components that can make a difference, said Dr. Walsh. Multidisciplinary heart failure programs also have an impact.
The participating hospitals will share their processes and models, and at the end of the 2 years, the hope is that the facilities will continue to fund the program, said Dr. Walsh.
The ACC will also “be interested to find out what success looks like,” she said.
The Patient Navigator Program probably won’t help hospitals avoid penalties until fiscal year 2017 at the earliest, Dr. Walsh noted. However, the model will still be important, she said.
“We know that value-based purchasing is moving on, and the penalties will almost certainly extend to other diagnoses each sequential year, so hospitals are interested in preparing for the future,” said Dr. Walsh.
On Twitter @aliciaault
A program that’s designed to help hospitals reduce readmissions after inpatient treatment for a heart attack or heart failure is being launched in 35 selected hospitals.
The Patient Navigator Program is sponsored by the American College of Cardiology and AstraZeneca, which provided $10 million in funding for the 2-year pilot program, but was not involved in selection of facilities or any other aspect.
It’s “a unique collaboration between the cardiovascular care team, patients, and families to manage the stress of hospitalization for complex conditions in a way that allows patients to return home, remain healthy, and avoid the need for readmission whenever possible,” said ACC President Patrick T. O’Gara, in a statement.
Hospitals have been under pressure to reduce readmissions since the fall of 2012. That’s when Medicare began penalizing facilities up to 1% of their inpatient admissions for excess readmissions within 30 days of patients with acute myocardial infarctions, heart failure, and pneumonia. The penalty increased to 2% in fiscal year 2014, and went up to 3% in the fiscal year that started Oct. 1. For this year, chronic obstructive pulmonary disease and hip/knee arthroplasty were added to the list of conditions being monitored for readmissions.
The penalties have already been assessed for fiscal year 2015.
Medicare’s Readmissions Reduction Program bases penalties on a prior 3-year period. Fiscal 2015 penalties were based on readmissions from 2010 to 2013.
The Medicare penalties were the driving force behind the creation of the program a few years ago, said Dr. Mary Norine Walsh, chair of the ACC’s Care Transition Oversight Program. But it also represented a chance “to pursue excellence,” said Dr. Walsh in an interview.
The 35 hospitals that are participating were selected by ACC senior staff and cardiologists like Dr. Walsh who are involved in the ACC’s quality improvement efforts. To be eligible, they had to be participants in the ACC’s National Cardiovascular Data Registry ACTION Registry–GWTG, which, according to the ACC, “is a risk-adjusted, outcomes-based quality improvement program that focuses exclusively on high-risk STEMI/NSTEMI myocardial infarction patients.” The registry helps hospitals apply ACC and American Heart Association clinical guideline recommendations and provides quality improvement tools.
They also had to be part of the ACC’s Hospital to Home Initiative, which helps hospitals and cardiovascular care providers improve transitions from hospital to homes.
All 35 hospitals are eligible to receive $80,000 a year for 2 years. Most likely, the facilities will use that money to hire an individual or individuals who can act as a navigator for heart failure and MI patients, said Dr. Walsh, who is the medical director of the heart failure and cardiac transplant program at St. Vincent Heart Center, Indianapolis, Ind.
While there are few randomized, controlled trials that examine what works to reduce readmission rates, there are several interventions that have been shown to help, she said. Patient eduction and getting patients in for follow-up care within 7 days are two key components that can make a difference, said Dr. Walsh. Multidisciplinary heart failure programs also have an impact.
The participating hospitals will share their processes and models, and at the end of the 2 years, the hope is that the facilities will continue to fund the program, said Dr. Walsh.
The ACC will also “be interested to find out what success looks like,” she said.
The Patient Navigator Program probably won’t help hospitals avoid penalties until fiscal year 2017 at the earliest, Dr. Walsh noted. However, the model will still be important, she said.
“We know that value-based purchasing is moving on, and the penalties will almost certainly extend to other diagnoses each sequential year, so hospitals are interested in preparing for the future,” said Dr. Walsh.
On Twitter @aliciaault
A program that’s designed to help hospitals reduce readmissions after inpatient treatment for a heart attack or heart failure is being launched in 35 selected hospitals.
The Patient Navigator Program is sponsored by the American College of Cardiology and AstraZeneca, which provided $10 million in funding for the 2-year pilot program, but was not involved in selection of facilities or any other aspect.
It’s “a unique collaboration between the cardiovascular care team, patients, and families to manage the stress of hospitalization for complex conditions in a way that allows patients to return home, remain healthy, and avoid the need for readmission whenever possible,” said ACC President Patrick T. O’Gara, in a statement.
Hospitals have been under pressure to reduce readmissions since the fall of 2012. That’s when Medicare began penalizing facilities up to 1% of their inpatient admissions for excess readmissions within 30 days of patients with acute myocardial infarctions, heart failure, and pneumonia. The penalty increased to 2% in fiscal year 2014, and went up to 3% in the fiscal year that started Oct. 1. For this year, chronic obstructive pulmonary disease and hip/knee arthroplasty were added to the list of conditions being monitored for readmissions.
The penalties have already been assessed for fiscal year 2015.
Medicare’s Readmissions Reduction Program bases penalties on a prior 3-year period. Fiscal 2015 penalties were based on readmissions from 2010 to 2013.
The Medicare penalties were the driving force behind the creation of the program a few years ago, said Dr. Mary Norine Walsh, chair of the ACC’s Care Transition Oversight Program. But it also represented a chance “to pursue excellence,” said Dr. Walsh in an interview.
The 35 hospitals that are participating were selected by ACC senior staff and cardiologists like Dr. Walsh who are involved in the ACC’s quality improvement efforts. To be eligible, they had to be participants in the ACC’s National Cardiovascular Data Registry ACTION Registry–GWTG, which, according to the ACC, “is a risk-adjusted, outcomes-based quality improvement program that focuses exclusively on high-risk STEMI/NSTEMI myocardial infarction patients.” The registry helps hospitals apply ACC and American Heart Association clinical guideline recommendations and provides quality improvement tools.
They also had to be part of the ACC’s Hospital to Home Initiative, which helps hospitals and cardiovascular care providers improve transitions from hospital to homes.
All 35 hospitals are eligible to receive $80,000 a year for 2 years. Most likely, the facilities will use that money to hire an individual or individuals who can act as a navigator for heart failure and MI patients, said Dr. Walsh, who is the medical director of the heart failure and cardiac transplant program at St. Vincent Heart Center, Indianapolis, Ind.
While there are few randomized, controlled trials that examine what works to reduce readmission rates, there are several interventions that have been shown to help, she said. Patient eduction and getting patients in for follow-up care within 7 days are two key components that can make a difference, said Dr. Walsh. Multidisciplinary heart failure programs also have an impact.
The participating hospitals will share their processes and models, and at the end of the 2 years, the hope is that the facilities will continue to fund the program, said Dr. Walsh.
The ACC will also “be interested to find out what success looks like,” she said.
The Patient Navigator Program probably won’t help hospitals avoid penalties until fiscal year 2017 at the earliest, Dr. Walsh noted. However, the model will still be important, she said.
“We know that value-based purchasing is moving on, and the penalties will almost certainly extend to other diagnoses each sequential year, so hospitals are interested in preparing for the future,” said Dr. Walsh.
On Twitter @aliciaault
House panel faults CDC’s Ebola response
WASHINGTON – Both Republicans and Democrats on the House Oversight and Government Reform committee said they believed the Centers for Disease Control and Prevention had not been acting quickly or consistently enough to protect health care workers and Americans from the Ebola virus.
Committee Chairman Darrell Issa (R-Calif.) said he felt that the agency had made recommendations on protective equipment that turned out to be ill advised. He also suggested that CDC Director Thomas Frieden had misled the American public about the potential for transmission.
“We have the head of CDC – he’s supposed to be the expert – and he’s made statements that simply aren’t true,” Rep. Issa said at the hearing, adding that the two nurses who were infected at a Dallas hospital had been wearing protective gear recommended by the CDC. “We’re relying on protocols from somebody who has proven not to be correct,” he said.
He asked whether Congress should view the federal government’s Ebola response as not just a singular mistake, but potentially a failure in preparedness for any infectious disease epidemic.
“Our failures largely relate to the fact that we’re learning some new things about Ebola,” said Dr. Nicole Lurie, assistant secretary for preparedness and response at the U.S. Department of Health & Human Services. “Ebola has never been in this hemisphere before, and as we’re learning those things we’re tightening up our policies and procedures as quickly as possible,” said Dr. Lurie.
Rep. Gerald Connolly (D-Va.) said that he, too, wanted answers, noting that “while CDC was giving us assurances about how hard it was to contract the disease,” two nurses were infected. “Do you think perhaps, not intentionally of course, in a zeal to assure the public, CDC misstepped?” he asked.
“I think that CDC has said that some missteps have been made,” said Dr. Lurie.
She labeled the response effort “a work in progress,” adding, “we are taking constant steps to adjust.”
Meanwhile, National Nurses United told the committee that it is asking President Obama to order hospitals to adopt a mandatory uniform of protective clothing and gear to help prevent any further contamination of health care workers.
Deborah Burger, copresident of the nurses’ group, told the panel that hospitals are still unprepared to treat any potential Ebola patients. She cited a survey by the group that found that 85% of responding registered nurses said they had not been adequately trained. Almost 70% said their facility had not communicated any policy regarding the potential admission of an Ebola patient.
“Every [registered nurse] who works in a hospital or healthcare facility could be Nina Pham or Amber Vinson, both of whom contracted Ebola while treating Thomas Eric Duncan at Texas Health Presbyterian Hospital in Dallas,” said Ms. Burger.
She noted that even though the CDC had recently updated its guidelines on what health care workers should wear when treating Ebola patients, those guidelines are “just guidelines.”
Ms. Burger added, “all 5,000 hospitals in the U.S.A. get to pick and choose what part of the guidelines they want to implement,” which is why her group was seeking a mandate for protective clothing and gear.
WASHINGTON – Both Republicans and Democrats on the House Oversight and Government Reform committee said they believed the Centers for Disease Control and Prevention had not been acting quickly or consistently enough to protect health care workers and Americans from the Ebola virus.
Committee Chairman Darrell Issa (R-Calif.) said he felt that the agency had made recommendations on protective equipment that turned out to be ill advised. He also suggested that CDC Director Thomas Frieden had misled the American public about the potential for transmission.
“We have the head of CDC – he’s supposed to be the expert – and he’s made statements that simply aren’t true,” Rep. Issa said at the hearing, adding that the two nurses who were infected at a Dallas hospital had been wearing protective gear recommended by the CDC. “We’re relying on protocols from somebody who has proven not to be correct,” he said.
He asked whether Congress should view the federal government’s Ebola response as not just a singular mistake, but potentially a failure in preparedness for any infectious disease epidemic.
“Our failures largely relate to the fact that we’re learning some new things about Ebola,” said Dr. Nicole Lurie, assistant secretary for preparedness and response at the U.S. Department of Health & Human Services. “Ebola has never been in this hemisphere before, and as we’re learning those things we’re tightening up our policies and procedures as quickly as possible,” said Dr. Lurie.
Rep. Gerald Connolly (D-Va.) said that he, too, wanted answers, noting that “while CDC was giving us assurances about how hard it was to contract the disease,” two nurses were infected. “Do you think perhaps, not intentionally of course, in a zeal to assure the public, CDC misstepped?” he asked.
“I think that CDC has said that some missteps have been made,” said Dr. Lurie.
She labeled the response effort “a work in progress,” adding, “we are taking constant steps to adjust.”
Meanwhile, National Nurses United told the committee that it is asking President Obama to order hospitals to adopt a mandatory uniform of protective clothing and gear to help prevent any further contamination of health care workers.
Deborah Burger, copresident of the nurses’ group, told the panel that hospitals are still unprepared to treat any potential Ebola patients. She cited a survey by the group that found that 85% of responding registered nurses said they had not been adequately trained. Almost 70% said their facility had not communicated any policy regarding the potential admission of an Ebola patient.
“Every [registered nurse] who works in a hospital or healthcare facility could be Nina Pham or Amber Vinson, both of whom contracted Ebola while treating Thomas Eric Duncan at Texas Health Presbyterian Hospital in Dallas,” said Ms. Burger.
She noted that even though the CDC had recently updated its guidelines on what health care workers should wear when treating Ebola patients, those guidelines are “just guidelines.”
Ms. Burger added, “all 5,000 hospitals in the U.S.A. get to pick and choose what part of the guidelines they want to implement,” which is why her group was seeking a mandate for protective clothing and gear.
WASHINGTON – Both Republicans and Democrats on the House Oversight and Government Reform committee said they believed the Centers for Disease Control and Prevention had not been acting quickly or consistently enough to protect health care workers and Americans from the Ebola virus.
Committee Chairman Darrell Issa (R-Calif.) said he felt that the agency had made recommendations on protective equipment that turned out to be ill advised. He also suggested that CDC Director Thomas Frieden had misled the American public about the potential for transmission.
“We have the head of CDC – he’s supposed to be the expert – and he’s made statements that simply aren’t true,” Rep. Issa said at the hearing, adding that the two nurses who were infected at a Dallas hospital had been wearing protective gear recommended by the CDC. “We’re relying on protocols from somebody who has proven not to be correct,” he said.
He asked whether Congress should view the federal government’s Ebola response as not just a singular mistake, but potentially a failure in preparedness for any infectious disease epidemic.
“Our failures largely relate to the fact that we’re learning some new things about Ebola,” said Dr. Nicole Lurie, assistant secretary for preparedness and response at the U.S. Department of Health & Human Services. “Ebola has never been in this hemisphere before, and as we’re learning those things we’re tightening up our policies and procedures as quickly as possible,” said Dr. Lurie.
Rep. Gerald Connolly (D-Va.) said that he, too, wanted answers, noting that “while CDC was giving us assurances about how hard it was to contract the disease,” two nurses were infected. “Do you think perhaps, not intentionally of course, in a zeal to assure the public, CDC misstepped?” he asked.
“I think that CDC has said that some missteps have been made,” said Dr. Lurie.
She labeled the response effort “a work in progress,” adding, “we are taking constant steps to adjust.”
Meanwhile, National Nurses United told the committee that it is asking President Obama to order hospitals to adopt a mandatory uniform of protective clothing and gear to help prevent any further contamination of health care workers.
Deborah Burger, copresident of the nurses’ group, told the panel that hospitals are still unprepared to treat any potential Ebola patients. She cited a survey by the group that found that 85% of responding registered nurses said they had not been adequately trained. Almost 70% said their facility had not communicated any policy regarding the potential admission of an Ebola patient.
“Every [registered nurse] who works in a hospital or healthcare facility could be Nina Pham or Amber Vinson, both of whom contracted Ebola while treating Thomas Eric Duncan at Texas Health Presbyterian Hospital in Dallas,” said Ms. Burger.
She noted that even though the CDC had recently updated its guidelines on what health care workers should wear when treating Ebola patients, those guidelines are “just guidelines.”
Ms. Burger added, “all 5,000 hospitals in the U.S.A. get to pick and choose what part of the guidelines they want to implement,” which is why her group was seeking a mandate for protective clothing and gear.
AT THE HOUSE OVERSIGHT COMMITTEE
AAFP launches campaign to boost primary care
WASHINGTON– The American Academy of Family Physicians is launching a 5-year strategic effort to help convince payers and policy makers to place a higher value on primary care and that getting back to basics is the way to achieve better health, better care, and lower costs.
Family physicians are best-positioned to deliver on that promise, known as the Triple Aim, said Dr. Glen Stream, in announcing the new campaign at the AAFP Scientific Assembly Oct. 23.
“We believe the solution to many – if not all – of our health care problems can be found in primary care,” said Dr. Stream, a past board chairman of AAFP, in a statement.
Dr. Stream is the chairman of the board of directors of Family Medicine for America’s Health, an organization that will tackle the work of “modernizing the family medicine specialty.” The group will focus on expanding access to the patient-centered medical home, building up the primary care workforce, and shifting from fee for service to a more comprehensive primary care payment model, Dr. Stream said.
One issue the campaign will work on: Advocating for the creation of primary care–specific evaluation and management codes.
“If you had a primary care code that was specifically designed to recognize the intensity and complexity of modern primary care practice and valued it accordingly, then you could change payment for primary care services,” said Dr. Stream, in an interview.
The campaign won’t focus only on physician income, but on “how do you have adequate payment into a medical home system that covers all of the services that patients need and deserve?”
The campaign will also focus on technology. There will be efforts to speak with one voice about improving electronic medical records systems. But the technology work group – one of six on the campaign – will more specifically look at ensuring that new inventions, whether they be at the bedside or on a smartphone – are effective in actually connecting physicians and patients and improve health outcomes.
As part of the overall strategic initiative, the AAFP is also launching “Health is Primary,” a public outreach project that will, among other things, visit a number of cities to showcase primary care interventions that are meeting the Triple Aim.
The cities have not been chosen yet, but the tour will begin in January, said Dr. Stream.
Dr. Don Berwick, who has been a chief promoter of the Triple Aim through the Institute for Healthcare Improvement, and when he was administrator of the Centers for Medicare & Medicaid Services, applauded the AAFP campaign.
“Bravo to family medicine for taking leadership here,” said Dr. Berwick at the briefing. “You’ll have me rooting for you from now on,” he said.
In a plenary address to the AAFP Scientific Assembly, Sylvia Burwell, secretary of the Department of Health and Human Services said, “When it comes to improving the way providers are paid, I want you to know that we share your commitment to rewarding value and care coordination, rather than volume and care duplication. Like you, we want to pay providers for what works – whether it’s something as complex as preventing or treating disease or something as straightforward as making sure that you have time to answer a patient’s questions.”
Although most of the campaign’s goals are aligned with those of the AAFP, its efforts are more urgent and more inclusive, Dr. Stream said. The campaign’s board includes representatives from the American Academy of Family Physicians Foundation, the American Board of Family Medicine, the American College of Osteopathic Family Physicians, the Association of Departments of Family Medicine, the Association of Family Medicine Residency Directors, the North American Primary Care Research Group, and the Society of Teachers of Family Medicine. Other board members include a rural physician, a new physician, an association executive, and a representative from the National Partnership for Women and Families.
WASHINGTON– The American Academy of Family Physicians is launching a 5-year strategic effort to help convince payers and policy makers to place a higher value on primary care and that getting back to basics is the way to achieve better health, better care, and lower costs.
Family physicians are best-positioned to deliver on that promise, known as the Triple Aim, said Dr. Glen Stream, in announcing the new campaign at the AAFP Scientific Assembly Oct. 23.
“We believe the solution to many – if not all – of our health care problems can be found in primary care,” said Dr. Stream, a past board chairman of AAFP, in a statement.
Dr. Stream is the chairman of the board of directors of Family Medicine for America’s Health, an organization that will tackle the work of “modernizing the family medicine specialty.” The group will focus on expanding access to the patient-centered medical home, building up the primary care workforce, and shifting from fee for service to a more comprehensive primary care payment model, Dr. Stream said.
One issue the campaign will work on: Advocating for the creation of primary care–specific evaluation and management codes.
“If you had a primary care code that was specifically designed to recognize the intensity and complexity of modern primary care practice and valued it accordingly, then you could change payment for primary care services,” said Dr. Stream, in an interview.
The campaign won’t focus only on physician income, but on “how do you have adequate payment into a medical home system that covers all of the services that patients need and deserve?”
The campaign will also focus on technology. There will be efforts to speak with one voice about improving electronic medical records systems. But the technology work group – one of six on the campaign – will more specifically look at ensuring that new inventions, whether they be at the bedside or on a smartphone – are effective in actually connecting physicians and patients and improve health outcomes.
As part of the overall strategic initiative, the AAFP is also launching “Health is Primary,” a public outreach project that will, among other things, visit a number of cities to showcase primary care interventions that are meeting the Triple Aim.
The cities have not been chosen yet, but the tour will begin in January, said Dr. Stream.
Dr. Don Berwick, who has been a chief promoter of the Triple Aim through the Institute for Healthcare Improvement, and when he was administrator of the Centers for Medicare & Medicaid Services, applauded the AAFP campaign.
“Bravo to family medicine for taking leadership here,” said Dr. Berwick at the briefing. “You’ll have me rooting for you from now on,” he said.
In a plenary address to the AAFP Scientific Assembly, Sylvia Burwell, secretary of the Department of Health and Human Services said, “When it comes to improving the way providers are paid, I want you to know that we share your commitment to rewarding value and care coordination, rather than volume and care duplication. Like you, we want to pay providers for what works – whether it’s something as complex as preventing or treating disease or something as straightforward as making sure that you have time to answer a patient’s questions.”
Although most of the campaign’s goals are aligned with those of the AAFP, its efforts are more urgent and more inclusive, Dr. Stream said. The campaign’s board includes representatives from the American Academy of Family Physicians Foundation, the American Board of Family Medicine, the American College of Osteopathic Family Physicians, the Association of Departments of Family Medicine, the Association of Family Medicine Residency Directors, the North American Primary Care Research Group, and the Society of Teachers of Family Medicine. Other board members include a rural physician, a new physician, an association executive, and a representative from the National Partnership for Women and Families.
WASHINGTON– The American Academy of Family Physicians is launching a 5-year strategic effort to help convince payers and policy makers to place a higher value on primary care and that getting back to basics is the way to achieve better health, better care, and lower costs.
Family physicians are best-positioned to deliver on that promise, known as the Triple Aim, said Dr. Glen Stream, in announcing the new campaign at the AAFP Scientific Assembly Oct. 23.
“We believe the solution to many – if not all – of our health care problems can be found in primary care,” said Dr. Stream, a past board chairman of AAFP, in a statement.
Dr. Stream is the chairman of the board of directors of Family Medicine for America’s Health, an organization that will tackle the work of “modernizing the family medicine specialty.” The group will focus on expanding access to the patient-centered medical home, building up the primary care workforce, and shifting from fee for service to a more comprehensive primary care payment model, Dr. Stream said.
One issue the campaign will work on: Advocating for the creation of primary care–specific evaluation and management codes.
“If you had a primary care code that was specifically designed to recognize the intensity and complexity of modern primary care practice and valued it accordingly, then you could change payment for primary care services,” said Dr. Stream, in an interview.
The campaign won’t focus only on physician income, but on “how do you have adequate payment into a medical home system that covers all of the services that patients need and deserve?”
The campaign will also focus on technology. There will be efforts to speak with one voice about improving electronic medical records systems. But the technology work group – one of six on the campaign – will more specifically look at ensuring that new inventions, whether they be at the bedside or on a smartphone – are effective in actually connecting physicians and patients and improve health outcomes.
As part of the overall strategic initiative, the AAFP is also launching “Health is Primary,” a public outreach project that will, among other things, visit a number of cities to showcase primary care interventions that are meeting the Triple Aim.
The cities have not been chosen yet, but the tour will begin in January, said Dr. Stream.
Dr. Don Berwick, who has been a chief promoter of the Triple Aim through the Institute for Healthcare Improvement, and when he was administrator of the Centers for Medicare & Medicaid Services, applauded the AAFP campaign.
“Bravo to family medicine for taking leadership here,” said Dr. Berwick at the briefing. “You’ll have me rooting for you from now on,” he said.
In a plenary address to the AAFP Scientific Assembly, Sylvia Burwell, secretary of the Department of Health and Human Services said, “When it comes to improving the way providers are paid, I want you to know that we share your commitment to rewarding value and care coordination, rather than volume and care duplication. Like you, we want to pay providers for what works – whether it’s something as complex as preventing or treating disease or something as straightforward as making sure that you have time to answer a patient’s questions.”
Although most of the campaign’s goals are aligned with those of the AAFP, its efforts are more urgent and more inclusive, Dr. Stream said. The campaign’s board includes representatives from the American Academy of Family Physicians Foundation, the American Board of Family Medicine, the American College of Osteopathic Family Physicians, the Association of Departments of Family Medicine, the Association of Family Medicine Residency Directors, the North American Primary Care Research Group, and the Society of Teachers of Family Medicine. Other board members include a rural physician, a new physician, an association executive, and a representative from the National Partnership for Women and Families.
New AAFP mission: No more Dr. Nice Guy
WASHINGTON – The American Academy of Family Physicians installed a new president and elected four* new board members and a president-elect, as all promised to take family medicine into a new, more focused, and more aggressive era.
The election results were announced Oct. 22 on the eve of the unveiling of a major new AAFP initiative, “Health is Primary,” which will seek to put family physicians at the forefront of the transformation of the health care system.
The details will be publicly released on Oct. 23, but in discussing the campaign with the Congress of Delegates, Dr. Glen R. Stream, a former AAFP president, said, “It is not self-serving to stand up and say the health care system needs solid primary care that’s well compensated to deliver that care in a medical home model.”
That goal “serves our patients and our country,” said Dr. Stream, who is in private practice in La Quinta, Calif. “We have got to get over ‘Family Medicine Nice.’ ”
Dr. Robert L. Wergin, who took over the helm as AAFP president, promised delegates that he would help them manage the challenges of the rapidly changing health care system and asked for their help. “We’ll finish this together and be winners in this health care delivery race,” he said.
Dr. Wergin, an AAFP member since 1982, practices in the town where he was born and raised – Milford, Neb. He’s chairman of the Milford public schools foundation board, and a team physician for the school district, and medical director of the town volunteer fire department. He was named Nebraska family physician of the year in 2002 and the state’s nursing home medical director of the year in 2012.
The new president-elect is Dr. Wanda Filer, a current AAFP board member who practices in York, Pa. She said that the new AAFP direction was “a completely new story.”
It will require the “mobilization of American family medicine,” with everyone coming to the table to explain why they are best positioned to lower costs, and improve access and quality, said Dr. Filer. In the next 3 to 5 years, “the message can be transformational for the American health care system.” New board member Dr. Lynne Lillie, said that she was ready to be a strong advocate for family medicine. “We as family practice physicians are overregulated, undercompensated, overburdened, and undervalued,” said Dr. Lillie, who is in private practice in Red Wing, Minn.
Noting a high level of burnout, a loss of job satisfaction, and declining empathy toward patients, she said,“This is not okay.”
Family physicians “deserve better and our patients deserve better,” said Dr. Lillie.
The Congress of Delegates also elected Dr. John S. Cullen of Valdez, Alaska, and Dr. Mott Blair, of Wallace, N.C., to full 3-year terms as directors. Dr. Cullen is the emergency medical services director for the Alaska Avalanche Information Center. Dr. Blair used to accompany his father, a family physician, on house calls, often into very rural areas. There, he learned “don’t step on a stick that moves,” he said.
The path ahead for family medicine is tricky – and may have sticks that move – but he said he was prepared to take on the challenges.
Dr. Carl Olden of Yakima, Wash., was the final new board member, and will serve the remainder of an expiring 1-year term and then be eligible to run again in 2015. Dr. Olden was born and raised in Toppenish, Wash., on the Yakima Indian Reservation.
After his residency, he went back to the reservation and practiced with the Indian Health Services from 1984 to 1995.
On Twitter @aliciaault
*Correction, 10/24/2014: An earlier version of this story misstated the number of new AAFP board members elected.
WASHINGTON – The American Academy of Family Physicians installed a new president and elected four* new board members and a president-elect, as all promised to take family medicine into a new, more focused, and more aggressive era.
The election results were announced Oct. 22 on the eve of the unveiling of a major new AAFP initiative, “Health is Primary,” which will seek to put family physicians at the forefront of the transformation of the health care system.
The details will be publicly released on Oct. 23, but in discussing the campaign with the Congress of Delegates, Dr. Glen R. Stream, a former AAFP president, said, “It is not self-serving to stand up and say the health care system needs solid primary care that’s well compensated to deliver that care in a medical home model.”
That goal “serves our patients and our country,” said Dr. Stream, who is in private practice in La Quinta, Calif. “We have got to get over ‘Family Medicine Nice.’ ”
Dr. Robert L. Wergin, who took over the helm as AAFP president, promised delegates that he would help them manage the challenges of the rapidly changing health care system and asked for their help. “We’ll finish this together and be winners in this health care delivery race,” he said.
Dr. Wergin, an AAFP member since 1982, practices in the town where he was born and raised – Milford, Neb. He’s chairman of the Milford public schools foundation board, and a team physician for the school district, and medical director of the town volunteer fire department. He was named Nebraska family physician of the year in 2002 and the state’s nursing home medical director of the year in 2012.
The new president-elect is Dr. Wanda Filer, a current AAFP board member who practices in York, Pa. She said that the new AAFP direction was “a completely new story.”
It will require the “mobilization of American family medicine,” with everyone coming to the table to explain why they are best positioned to lower costs, and improve access and quality, said Dr. Filer. In the next 3 to 5 years, “the message can be transformational for the American health care system.” New board member Dr. Lynne Lillie, said that she was ready to be a strong advocate for family medicine. “We as family practice physicians are overregulated, undercompensated, overburdened, and undervalued,” said Dr. Lillie, who is in private practice in Red Wing, Minn.
Noting a high level of burnout, a loss of job satisfaction, and declining empathy toward patients, she said,“This is not okay.”
Family physicians “deserve better and our patients deserve better,” said Dr. Lillie.
The Congress of Delegates also elected Dr. John S. Cullen of Valdez, Alaska, and Dr. Mott Blair, of Wallace, N.C., to full 3-year terms as directors. Dr. Cullen is the emergency medical services director for the Alaska Avalanche Information Center. Dr. Blair used to accompany his father, a family physician, on house calls, often into very rural areas. There, he learned “don’t step on a stick that moves,” he said.
The path ahead for family medicine is tricky – and may have sticks that move – but he said he was prepared to take on the challenges.
Dr. Carl Olden of Yakima, Wash., was the final new board member, and will serve the remainder of an expiring 1-year term and then be eligible to run again in 2015. Dr. Olden was born and raised in Toppenish, Wash., on the Yakima Indian Reservation.
After his residency, he went back to the reservation and practiced with the Indian Health Services from 1984 to 1995.
On Twitter @aliciaault
*Correction, 10/24/2014: An earlier version of this story misstated the number of new AAFP board members elected.
WASHINGTON – The American Academy of Family Physicians installed a new president and elected four* new board members and a president-elect, as all promised to take family medicine into a new, more focused, and more aggressive era.
The election results were announced Oct. 22 on the eve of the unveiling of a major new AAFP initiative, “Health is Primary,” which will seek to put family physicians at the forefront of the transformation of the health care system.
The details will be publicly released on Oct. 23, but in discussing the campaign with the Congress of Delegates, Dr. Glen R. Stream, a former AAFP president, said, “It is not self-serving to stand up and say the health care system needs solid primary care that’s well compensated to deliver that care in a medical home model.”
That goal “serves our patients and our country,” said Dr. Stream, who is in private practice in La Quinta, Calif. “We have got to get over ‘Family Medicine Nice.’ ”
Dr. Robert L. Wergin, who took over the helm as AAFP president, promised delegates that he would help them manage the challenges of the rapidly changing health care system and asked for their help. “We’ll finish this together and be winners in this health care delivery race,” he said.
Dr. Wergin, an AAFP member since 1982, practices in the town where he was born and raised – Milford, Neb. He’s chairman of the Milford public schools foundation board, and a team physician for the school district, and medical director of the town volunteer fire department. He was named Nebraska family physician of the year in 2002 and the state’s nursing home medical director of the year in 2012.
The new president-elect is Dr. Wanda Filer, a current AAFP board member who practices in York, Pa. She said that the new AAFP direction was “a completely new story.”
It will require the “mobilization of American family medicine,” with everyone coming to the table to explain why they are best positioned to lower costs, and improve access and quality, said Dr. Filer. In the next 3 to 5 years, “the message can be transformational for the American health care system.” New board member Dr. Lynne Lillie, said that she was ready to be a strong advocate for family medicine. “We as family practice physicians are overregulated, undercompensated, overburdened, and undervalued,” said Dr. Lillie, who is in private practice in Red Wing, Minn.
Noting a high level of burnout, a loss of job satisfaction, and declining empathy toward patients, she said,“This is not okay.”
Family physicians “deserve better and our patients deserve better,” said Dr. Lillie.
The Congress of Delegates also elected Dr. John S. Cullen of Valdez, Alaska, and Dr. Mott Blair, of Wallace, N.C., to full 3-year terms as directors. Dr. Cullen is the emergency medical services director for the Alaska Avalanche Information Center. Dr. Blair used to accompany his father, a family physician, on house calls, often into very rural areas. There, he learned “don’t step on a stick that moves,” he said.
The path ahead for family medicine is tricky – and may have sticks that move – but he said he was prepared to take on the challenges.
Dr. Carl Olden of Yakima, Wash., was the final new board member, and will serve the remainder of an expiring 1-year term and then be eligible to run again in 2015. Dr. Olden was born and raised in Toppenish, Wash., on the Yakima Indian Reservation.
After his residency, he went back to the reservation and practiced with the Indian Health Services from 1984 to 1995.
On Twitter @aliciaault
*Correction, 10/24/2014: An earlier version of this story misstated the number of new AAFP board members elected.
AT THE AAFP CONGRESS OF DELEGATES
