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FDA approves omalizumab for chronic idiopathic urticaria
The Food and Drug Administration has approved omalizumab (Xolair) for chronic idiopathic urticaria in people 12 years of age and older who remain symptomatic despite treatment with H1-antihistamine therapy.
Omalizumab was first approved in 2003 for moderate to severe asthma. In 2007, the FDA required the drug to be administered in a doctor’s office only, to monitor for potentially severe anaphylaxis; a boxed warning was added at that time.
According to the drug’s developer, Genentech, omalizumab is the first biologic and the first medicine approved for chronic idiopathic urticaria since nonsedating H1-antihistamines.
The approval was based on the results from two studies, ASTERIA I and ASTERIA II5, which were presented in November 2013 at the annual congress of the European Academy of Dermatology and Venereology.
According to Genentech, about 1.5 million Americans develop chronic idiopathic urticaria at some point, with women twice as likely as men to get the condition.
Chronic idiopathic urticaria "can be a frustrating condition for patients," said Mike Tringale, senior vice president at the Asthma and Allergy Foundation of America in a statement issued by Genentech. "This new use for Xolair gives hope to appropriate patients who can go for months or even years without getting satisfactory itch and hive reduction."
Omalizumab was jointly developed by Genentech and Novartis Pharma, and is copromoted in the United States with Novartis.
[email protected] On Twitter @aliciaault
The Food and Drug Administration has approved omalizumab (Xolair) for chronic idiopathic urticaria in people 12 years of age and older who remain symptomatic despite treatment with H1-antihistamine therapy.
Omalizumab was first approved in 2003 for moderate to severe asthma. In 2007, the FDA required the drug to be administered in a doctor’s office only, to monitor for potentially severe anaphylaxis; a boxed warning was added at that time.
According to the drug’s developer, Genentech, omalizumab is the first biologic and the first medicine approved for chronic idiopathic urticaria since nonsedating H1-antihistamines.
The approval was based on the results from two studies, ASTERIA I and ASTERIA II5, which were presented in November 2013 at the annual congress of the European Academy of Dermatology and Venereology.
According to Genentech, about 1.5 million Americans develop chronic idiopathic urticaria at some point, with women twice as likely as men to get the condition.
Chronic idiopathic urticaria "can be a frustrating condition for patients," said Mike Tringale, senior vice president at the Asthma and Allergy Foundation of America in a statement issued by Genentech. "This new use for Xolair gives hope to appropriate patients who can go for months or even years without getting satisfactory itch and hive reduction."
Omalizumab was jointly developed by Genentech and Novartis Pharma, and is copromoted in the United States with Novartis.
[email protected] On Twitter @aliciaault
The Food and Drug Administration has approved omalizumab (Xolair) for chronic idiopathic urticaria in people 12 years of age and older who remain symptomatic despite treatment with H1-antihistamine therapy.
Omalizumab was first approved in 2003 for moderate to severe asthma. In 2007, the FDA required the drug to be administered in a doctor’s office only, to monitor for potentially severe anaphylaxis; a boxed warning was added at that time.
According to the drug’s developer, Genentech, omalizumab is the first biologic and the first medicine approved for chronic idiopathic urticaria since nonsedating H1-antihistamines.
The approval was based on the results from two studies, ASTERIA I and ASTERIA II5, which were presented in November 2013 at the annual congress of the European Academy of Dermatology and Venereology.
According to Genentech, about 1.5 million Americans develop chronic idiopathic urticaria at some point, with women twice as likely as men to get the condition.
Chronic idiopathic urticaria "can be a frustrating condition for patients," said Mike Tringale, senior vice president at the Asthma and Allergy Foundation of America in a statement issued by Genentech. "This new use for Xolair gives hope to appropriate patients who can go for months or even years without getting satisfactory itch and hive reduction."
Omalizumab was jointly developed by Genentech and Novartis Pharma, and is copromoted in the United States with Novartis.
[email protected] On Twitter @aliciaault
Doctors may not get paid for care if patients don’t pay their ACA premiums
Will you get paid for the care you provide to patients who have gained insurance coverage through the Affordable Care Act’s health insurance claims? You’ll soon find out.
Under the health reform law, patients must pay their first month’s premium to be considered enrolled; they then have 90 days to pay the next premium.
If the patient doesn’t pay his or her premiums for the second month, the insurer can hold or "pend" all claims. By the third month, if the patient still has not paid, the insurer can terminate his or her policy. The physician is left to collect whatever is owed for all outstanding claims from the patient.
The Centers for Medicare and Medicaid Services (CMS) clarified the grace period policy in a letter to insurers last year.
The first ripples could come in April. Patients who started and paid for coverage in January, but who did not pay in February or March, might get dropped from coverage. That could leave physicians scrambling to cover the unreimbursed care.
Physicians’ organizations including the American Medical Association, the American College of Physicians, and the American Academy of Family Physicians have been working to reverse this provision of the Affordable Care Act, to no avail so far.
In a March 5 letter to the CMS, dozens of organizations and state medical societies urged the agency to require insurers to tell physicians whether patients had up-to-date coverage during the verification of eligibility. As the law and current regulations are written, insurers can notify physicians on their own timeline whether a patient’s coverage has lapsed.
The organizations also asked the CMS to "require issuers to assume full financial responsibility if an issuer provides inaccurate eligibility information during the last 60 days of the grace period."
"Managing risk is typically a role for insurers, but the grace period rule transfers two-thirds of that risk from the insurers to physicians and health care providers," Dr. Ardis Dee Hoven, president of the American Medical Association, said in a statement.
She added that the AMA is now offering some resources to help physicians manage the "potential negative impact" from having unwittingly given uncompensated care.
Among the resources is a sample letter for patients that explains the 90-day grace period and the importance of paying premiums on a timely basis and in full. The AMA also provides a step-by-step outline suggesting how to collect from patients whose coverage has lapsed.
It is unclear how many individuals have paid for coverage under the Affordable Care Act. The Health and Human Services department said on March 17 that 5 million Americans have signed up for coverage through the state and federal exchanges since Oct. 1. But the department continues to say that it does not know how many have paid their premiums.
On Twitter @aliciaault
Will you get paid for the care you provide to patients who have gained insurance coverage through the Affordable Care Act’s health insurance claims? You’ll soon find out.
Under the health reform law, patients must pay their first month’s premium to be considered enrolled; they then have 90 days to pay the next premium.
If the patient doesn’t pay his or her premiums for the second month, the insurer can hold or "pend" all claims. By the third month, if the patient still has not paid, the insurer can terminate his or her policy. The physician is left to collect whatever is owed for all outstanding claims from the patient.
The Centers for Medicare and Medicaid Services (CMS) clarified the grace period policy in a letter to insurers last year.
The first ripples could come in April. Patients who started and paid for coverage in January, but who did not pay in February or March, might get dropped from coverage. That could leave physicians scrambling to cover the unreimbursed care.
Physicians’ organizations including the American Medical Association, the American College of Physicians, and the American Academy of Family Physicians have been working to reverse this provision of the Affordable Care Act, to no avail so far.
In a March 5 letter to the CMS, dozens of organizations and state medical societies urged the agency to require insurers to tell physicians whether patients had up-to-date coverage during the verification of eligibility. As the law and current regulations are written, insurers can notify physicians on their own timeline whether a patient’s coverage has lapsed.
The organizations also asked the CMS to "require issuers to assume full financial responsibility if an issuer provides inaccurate eligibility information during the last 60 days of the grace period."
"Managing risk is typically a role for insurers, but the grace period rule transfers two-thirds of that risk from the insurers to physicians and health care providers," Dr. Ardis Dee Hoven, president of the American Medical Association, said in a statement.
She added that the AMA is now offering some resources to help physicians manage the "potential negative impact" from having unwittingly given uncompensated care.
Among the resources is a sample letter for patients that explains the 90-day grace period and the importance of paying premiums on a timely basis and in full. The AMA also provides a step-by-step outline suggesting how to collect from patients whose coverage has lapsed.
It is unclear how many individuals have paid for coverage under the Affordable Care Act. The Health and Human Services department said on March 17 that 5 million Americans have signed up for coverage through the state and federal exchanges since Oct. 1. But the department continues to say that it does not know how many have paid their premiums.
On Twitter @aliciaault
Will you get paid for the care you provide to patients who have gained insurance coverage through the Affordable Care Act’s health insurance claims? You’ll soon find out.
Under the health reform law, patients must pay their first month’s premium to be considered enrolled; they then have 90 days to pay the next premium.
If the patient doesn’t pay his or her premiums for the second month, the insurer can hold or "pend" all claims. By the third month, if the patient still has not paid, the insurer can terminate his or her policy. The physician is left to collect whatever is owed for all outstanding claims from the patient.
The Centers for Medicare and Medicaid Services (CMS) clarified the grace period policy in a letter to insurers last year.
The first ripples could come in April. Patients who started and paid for coverage in January, but who did not pay in February or March, might get dropped from coverage. That could leave physicians scrambling to cover the unreimbursed care.
Physicians’ organizations including the American Medical Association, the American College of Physicians, and the American Academy of Family Physicians have been working to reverse this provision of the Affordable Care Act, to no avail so far.
In a March 5 letter to the CMS, dozens of organizations and state medical societies urged the agency to require insurers to tell physicians whether patients had up-to-date coverage during the verification of eligibility. As the law and current regulations are written, insurers can notify physicians on their own timeline whether a patient’s coverage has lapsed.
The organizations also asked the CMS to "require issuers to assume full financial responsibility if an issuer provides inaccurate eligibility information during the last 60 days of the grace period."
"Managing risk is typically a role for insurers, but the grace period rule transfers two-thirds of that risk from the insurers to physicians and health care providers," Dr. Ardis Dee Hoven, president of the American Medical Association, said in a statement.
She added that the AMA is now offering some resources to help physicians manage the "potential negative impact" from having unwittingly given uncompensated care.
Among the resources is a sample letter for patients that explains the 90-day grace period and the importance of paying premiums on a timely basis and in full. The AMA also provides a step-by-step outline suggesting how to collect from patients whose coverage has lapsed.
It is unclear how many individuals have paid for coverage under the Affordable Care Act. The Health and Human Services department said on March 17 that 5 million Americans have signed up for coverage through the state and federal exchanges since Oct. 1. But the department continues to say that it does not know how many have paid their premiums.
On Twitter @aliciaault
Autoimmune patients report mixed results with new ACA coverage
WASHINGTON – Almost half of patients with autoimmune disorders report that they face higher costs with their new Affordable Care Act coverage while just under half report they are better off than before the law went into effect.
Those are the top-line results of a non–random-sample survey of about 400 autoimmune patients released by the American Autoimmune Related Diseases Association (AARDA) on March 18.
Among all respondents, 26% said that they had to buy a new insurance plan when the health insurance marketplaces began this year; 62% did not. Overall, 42% said that their premiums had increased, but that number includes some people who were previously uninsured, and thus, were not paying premiums at all, said Stephanie Hales, a lawyer in Washington, who represents the association.
A third of respondents reported that their deductibles for either medical services or prescription drugs had increased, while 40% said their deductible had not changed. More than a third (36%) of respondents said that coverage of the services that were important to them had decreased. The ACA requires insurance companies to provide a comprehensive set of benefits.
More than half said their coverage had stayed the same or was better.
In terms of prescription drug coverage, almost 40% of patients said they were paying more.
Most survey participants (66%) also said that they were able to keep their specialist, and almost half said that they had the same accessibility. But 33% said they had experienced access issues.
The survey shows "that the ACA has helped many people so far, but that continued improvements are needed to ensure that the ACA is implemented in a way that meets the needs of patients with serious and chronic conditions, including autoimmune diseases," said Ms. Hales.
The survey was conducted to help determine how to address concerns and complaints that the various autoimmune associations have heard from patients since the enrollment period for the ACA started in October, AARDA president Virginia T. Ladd said in an interview.
The association plans to survey members again a few months after enrollment closes on March 31, to gauge the impact on access to specialists and to medications.
The small survey of about 400 patients was not random; respondents were solicited through the organizations’ websites, and most of the data were collected in January and February.
On Twitter @aliciaault
WASHINGTON – Almost half of patients with autoimmune disorders report that they face higher costs with their new Affordable Care Act coverage while just under half report they are better off than before the law went into effect.
Those are the top-line results of a non–random-sample survey of about 400 autoimmune patients released by the American Autoimmune Related Diseases Association (AARDA) on March 18.
Among all respondents, 26% said that they had to buy a new insurance plan when the health insurance marketplaces began this year; 62% did not. Overall, 42% said that their premiums had increased, but that number includes some people who were previously uninsured, and thus, were not paying premiums at all, said Stephanie Hales, a lawyer in Washington, who represents the association.
A third of respondents reported that their deductibles for either medical services or prescription drugs had increased, while 40% said their deductible had not changed. More than a third (36%) of respondents said that coverage of the services that were important to them had decreased. The ACA requires insurance companies to provide a comprehensive set of benefits.
More than half said their coverage had stayed the same or was better.
In terms of prescription drug coverage, almost 40% of patients said they were paying more.
Most survey participants (66%) also said that they were able to keep their specialist, and almost half said that they had the same accessibility. But 33% said they had experienced access issues.
The survey shows "that the ACA has helped many people so far, but that continued improvements are needed to ensure that the ACA is implemented in a way that meets the needs of patients with serious and chronic conditions, including autoimmune diseases," said Ms. Hales.
The survey was conducted to help determine how to address concerns and complaints that the various autoimmune associations have heard from patients since the enrollment period for the ACA started in October, AARDA president Virginia T. Ladd said in an interview.
The association plans to survey members again a few months after enrollment closes on March 31, to gauge the impact on access to specialists and to medications.
The small survey of about 400 patients was not random; respondents were solicited through the organizations’ websites, and most of the data were collected in January and February.
On Twitter @aliciaault
WASHINGTON – Almost half of patients with autoimmune disorders report that they face higher costs with their new Affordable Care Act coverage while just under half report they are better off than before the law went into effect.
Those are the top-line results of a non–random-sample survey of about 400 autoimmune patients released by the American Autoimmune Related Diseases Association (AARDA) on March 18.
Among all respondents, 26% said that they had to buy a new insurance plan when the health insurance marketplaces began this year; 62% did not. Overall, 42% said that their premiums had increased, but that number includes some people who were previously uninsured, and thus, were not paying premiums at all, said Stephanie Hales, a lawyer in Washington, who represents the association.
A third of respondents reported that their deductibles for either medical services or prescription drugs had increased, while 40% said their deductible had not changed. More than a third (36%) of respondents said that coverage of the services that were important to them had decreased. The ACA requires insurance companies to provide a comprehensive set of benefits.
More than half said their coverage had stayed the same or was better.
In terms of prescription drug coverage, almost 40% of patients said they were paying more.
Most survey participants (66%) also said that they were able to keep their specialist, and almost half said that they had the same accessibility. But 33% said they had experienced access issues.
The survey shows "that the ACA has helped many people so far, but that continued improvements are needed to ensure that the ACA is implemented in a way that meets the needs of patients with serious and chronic conditions, including autoimmune diseases," said Ms. Hales.
The survey was conducted to help determine how to address concerns and complaints that the various autoimmune associations have heard from patients since the enrollment period for the ACA started in October, AARDA president Virginia T. Ladd said in an interview.
The association plans to survey members again a few months after enrollment closes on March 31, to gauge the impact on access to specialists and to medications.
The small survey of about 400 patients was not random; respondents were solicited through the organizations’ websites, and most of the data were collected in January and February.
On Twitter @aliciaault
Autoimmune disease coalition seeks to increase physician knowledge
WASHINGTON – Some 64% of family physicians are "uncomfortable" or "stressed" when diagnosing autoimmune disease, and almost three-quarters said they have not been given adequate training in diagnosing and treating the conditions, according to a small survey.
The survey of 130 family physicians was conducted by the American Autoimmune Related Diseases Association (AARDA) last fall. The association has queried physicians each year since the mid-1990s on a variety of issues relating to the care and treatment of patients with any one of the 100 or so diseases that fall into the autoimmune category.
The AARDA, along with the National Coalition of Autoimmune Patient Groups, is pushing for more comprehensive autoimmune disorder centers where patients can receive focused and coordinated care from specialists who are more intimately involved with the diseases.
The autoimmune facilities would be modeled on comprehensive cancer centers.
Now, patients struggle to find specialists who can accurately diagnose and treat their conditions. "There’s no such thing as the autoimmunologist," said Stanley Finger, Ph.D., the AARDA’s vice chairman of the board, at a briefing.
Patients responding to AARDA surveys report that it takes 4-5 years to get an accurate diagnosis, and that they see an average of five physicians before they get that diagnosis. At least half of patients are labeled chronic complainers and told that their symptoms are figments of their imagination, Dr. Finger said.
But 75% say they would seek care at a specialized center if it existed.
Improving diagnosis also requires increasing physician awareness and education. In the AARDA’s most recent survey, almost 60% of family physicians said that they had only one or two lectures on autoimmune disease in medical school, said Dr. Finger, who is also president of Environmental Consulting and Investigations in Bluffton, S.C.
"It doesn’t give a lot of time for these physicians to become experts," Dr. Finger said. "Because of that, they don’t feel very good about the training they have received."
The AARDA plans to develop a syllabus for medical schools and a continuing education program to help fill physicians’ knowledge gaps.
The group also surveys about 1,000 members of the general public every 5-7 years to gauge awareness of how patients are interacting with physicians. In 1992, only 5% could name an autoimmune disease. That has increased, but only to 15%. In the first survey, 93% of the public thought AIDS was an autoimmune disease. Now, just 21% have that belief.
Borrowing another page from the cancer model, the AARDA and the coalition are seeking to establish an autoimmune disease registry that would be similar to the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program. The SEER program compiles data about cancer incidence, mortality, and cost. It is widely used by researchers, patients, physicians, and public health agencies.
The autoimmune registry is still a work in progress. There is a huge absence of data in the autoimmune field – for example, no one knows with certainty just how many Americans have any of the various conditions, said Aaron H. Abend, the AARDA’s informatics director.
The registry would aggregate data already being compiled by various individual autoimmune associations. But the effort is in its infancy. The groups still need to agree on governance, data protocols, and other issues, Mr. Abend said. However, the registry will use software that is the standard for registries operated by the National Institutes of Health.
[email protected]
On Twitter @aliciaault
WASHINGTON – Some 64% of family physicians are "uncomfortable" or "stressed" when diagnosing autoimmune disease, and almost three-quarters said they have not been given adequate training in diagnosing and treating the conditions, according to a small survey.
The survey of 130 family physicians was conducted by the American Autoimmune Related Diseases Association (AARDA) last fall. The association has queried physicians each year since the mid-1990s on a variety of issues relating to the care and treatment of patients with any one of the 100 or so diseases that fall into the autoimmune category.
The AARDA, along with the National Coalition of Autoimmune Patient Groups, is pushing for more comprehensive autoimmune disorder centers where patients can receive focused and coordinated care from specialists who are more intimately involved with the diseases.
The autoimmune facilities would be modeled on comprehensive cancer centers.
Now, patients struggle to find specialists who can accurately diagnose and treat their conditions. "There’s no such thing as the autoimmunologist," said Stanley Finger, Ph.D., the AARDA’s vice chairman of the board, at a briefing.
Patients responding to AARDA surveys report that it takes 4-5 years to get an accurate diagnosis, and that they see an average of five physicians before they get that diagnosis. At least half of patients are labeled chronic complainers and told that their symptoms are figments of their imagination, Dr. Finger said.
But 75% say they would seek care at a specialized center if it existed.
Improving diagnosis also requires increasing physician awareness and education. In the AARDA’s most recent survey, almost 60% of family physicians said that they had only one or two lectures on autoimmune disease in medical school, said Dr. Finger, who is also president of Environmental Consulting and Investigations in Bluffton, S.C.
"It doesn’t give a lot of time for these physicians to become experts," Dr. Finger said. "Because of that, they don’t feel very good about the training they have received."
The AARDA plans to develop a syllabus for medical schools and a continuing education program to help fill physicians’ knowledge gaps.
The group also surveys about 1,000 members of the general public every 5-7 years to gauge awareness of how patients are interacting with physicians. In 1992, only 5% could name an autoimmune disease. That has increased, but only to 15%. In the first survey, 93% of the public thought AIDS was an autoimmune disease. Now, just 21% have that belief.
Borrowing another page from the cancer model, the AARDA and the coalition are seeking to establish an autoimmune disease registry that would be similar to the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program. The SEER program compiles data about cancer incidence, mortality, and cost. It is widely used by researchers, patients, physicians, and public health agencies.
The autoimmune registry is still a work in progress. There is a huge absence of data in the autoimmune field – for example, no one knows with certainty just how many Americans have any of the various conditions, said Aaron H. Abend, the AARDA’s informatics director.
The registry would aggregate data already being compiled by various individual autoimmune associations. But the effort is in its infancy. The groups still need to agree on governance, data protocols, and other issues, Mr. Abend said. However, the registry will use software that is the standard for registries operated by the National Institutes of Health.
[email protected]
On Twitter @aliciaault
WASHINGTON – Some 64% of family physicians are "uncomfortable" or "stressed" when diagnosing autoimmune disease, and almost three-quarters said they have not been given adequate training in diagnosing and treating the conditions, according to a small survey.
The survey of 130 family physicians was conducted by the American Autoimmune Related Diseases Association (AARDA) last fall. The association has queried physicians each year since the mid-1990s on a variety of issues relating to the care and treatment of patients with any one of the 100 or so diseases that fall into the autoimmune category.
The AARDA, along with the National Coalition of Autoimmune Patient Groups, is pushing for more comprehensive autoimmune disorder centers where patients can receive focused and coordinated care from specialists who are more intimately involved with the diseases.
The autoimmune facilities would be modeled on comprehensive cancer centers.
Now, patients struggle to find specialists who can accurately diagnose and treat their conditions. "There’s no such thing as the autoimmunologist," said Stanley Finger, Ph.D., the AARDA’s vice chairman of the board, at a briefing.
Patients responding to AARDA surveys report that it takes 4-5 years to get an accurate diagnosis, and that they see an average of five physicians before they get that diagnosis. At least half of patients are labeled chronic complainers and told that their symptoms are figments of their imagination, Dr. Finger said.
But 75% say they would seek care at a specialized center if it existed.
Improving diagnosis also requires increasing physician awareness and education. In the AARDA’s most recent survey, almost 60% of family physicians said that they had only one or two lectures on autoimmune disease in medical school, said Dr. Finger, who is also president of Environmental Consulting and Investigations in Bluffton, S.C.
"It doesn’t give a lot of time for these physicians to become experts," Dr. Finger said. "Because of that, they don’t feel very good about the training they have received."
The AARDA plans to develop a syllabus for medical schools and a continuing education program to help fill physicians’ knowledge gaps.
The group also surveys about 1,000 members of the general public every 5-7 years to gauge awareness of how patients are interacting with physicians. In 1992, only 5% could name an autoimmune disease. That has increased, but only to 15%. In the first survey, 93% of the public thought AIDS was an autoimmune disease. Now, just 21% have that belief.
Borrowing another page from the cancer model, the AARDA and the coalition are seeking to establish an autoimmune disease registry that would be similar to the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program. The SEER program compiles data about cancer incidence, mortality, and cost. It is widely used by researchers, patients, physicians, and public health agencies.
The autoimmune registry is still a work in progress. There is a huge absence of data in the autoimmune field – for example, no one knows with certainty just how many Americans have any of the various conditions, said Aaron H. Abend, the AARDA’s informatics director.
The registry would aggregate data already being compiled by various individual autoimmune associations. But the effort is in its infancy. The groups still need to agree on governance, data protocols, and other issues, Mr. Abend said. However, the registry will use software that is the standard for registries operated by the National Institutes of Health.
[email protected]
On Twitter @aliciaault
FROM A MEDIA BRIEFING BY THE AMERICAN AUTOIMMUNE RELATED DISEASES ASSOCIATION
Groups launch CRC screening campaign as incidence declines
WASHINGTON – Several dozen organizations have joined together to help increase colorectal cancer screening rates to 80% of all Americans by 2018, citing the success of campaigns over the past decade that led to a 30% decline in incidence in individuals over age 50.
The National Colorectal Cancer Roundtable is leading the 80% by 2018 effort, saying that 1 in 3 adults between the ages of 50 and 75 years, or 23 million Americans, are not getting recommended screening.
Colorectal cancer is the third-leading cause of cancer death in the United States. In 2014, there will be an estimated 136,830 new diagnoses and 50,310 deaths. Sixty percent of the cases and 70% of the deaths are in those over age 65.
"Our goal today is absolutely clear: to eliminate colorectal cancer as a major public health threat," said Dr. Howard Koh, assistant secretary for health at the Health and Human Services department. HHS will be part of the campaign, along with state health departments; patient advocates; the American Association of Retired Persons (AARP); the American Cancer Society (ACS); and physician organizations, including the American College of Gastroenterology, the American College of Radiology, and the American Society for Gastrointestinal Endoscopy.
Dr. Koh spoke at a March 17 briefing sponsored by the ACS, which also published an analysis that day showing a decline in colorectal cancer incidence and mortality for most age groups, but for older Americans, in particular.
The study was published online in CA: A Cancer Journal for Clinicians, and was based on data from the Centers for Disease Control and Prevention’s National Center for Health Statistics; the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program; and the CDC’s National Program of Cancer Registries.
Overall, the incidence of colorectal cancer decreased by an average 3.4% per year from 2001 to 2010. The biggest declines were in people aged 50 years or older – at 3.9% per year, or a 30% decline over that decade. For people over age 65, the decline has been particularly notable—3.6% a year from 2001 to 2008 and 7.2% a year during 2008-2010.
The authors attribute that decline to a growth in screening. In 2000, 19% of Americans aged 50-75 years received some kind of screen. By 2010, the number had jumped to 55%.
"In other words, we are making real progress," said John R. Seffrin, chief executive officer of the ACS, at the briefing.
Some of the screening increase was due to Medicare coverage of all screening methods, including the fecal occult blood test, colonoscopy, and sigmoidoscopy. Sixty-four percent of Americans over age 65 had a screening test in 2010, compared with 55% of those in the 50- to 64-year-old group not covered by Medicare. Screening rates are highest in well-educated Americans who have health insurance, and in whites. Only a quarter of recent immigrants – those in the United States less than 10 years – were screened, compared with 62% of non-Hispanic whites. And only 18% of the uninsured had a screening exam in 2010, compared with 62% of those with insurance.
Just having insurance does not guarantee that screening will be cost-free, even though it is covered under Medicare and is an essential benefit under policies covered by the Affordable Care Act.
If polyps are found and removed, however, Medicare patients and others with private insurance often find themselves facing large copayments or lack of coverage for subsequent screenings. Gastroenterologists want to see an end to that "postpolypectomy surprise," said Dr. Ronald Vender, immediate past president of the American College of Gastroenterology, at the briefing.
The Removing Barriers to Colorectal Cancer Screening Act (H.R. 1070), which would cover any of those subsequent costs, was introduced in Congress in March 2013.
There are still major disparities in colorectal cancer incidence and mortality rates. Incidence and mortality rates are 30-40% higher in men than women. Incidence and mortality are highest in African Americans and lowest among Asian Pacific Islanders. From 2006 to 2010, the incidence in blacks was 25% higher than in whites and 50% higher than in Asian Pacific Islanders. Mortality rates are 50% higher for blacks than for whites, at 29.4 per 100,000. The higher incidence and mortality in blacks may be due to a lower socioeconomic status, but there are also other factors at play, said the authors, noting that rates are higher even for blacks in the same socioeconomic status as white peers.
Survival rates do not vary substantially by sex, according to the paper. While 5-year survival rates are relatively high – at 65% – only 40% of patients are diagnosed when the disease is localized. The 5-year survival at that stage is 90%.
But survival among blacks is the lowest among any race, 10% lower than for Asian Pacific Islanders, which have the best rates. Survival rates are lowest in high-poverty areas of America, including Appalachia and the mid-South, according to the ACS report.
On Twitter @aliciaault
WASHINGTON – Several dozen organizations have joined together to help increase colorectal cancer screening rates to 80% of all Americans by 2018, citing the success of campaigns over the past decade that led to a 30% decline in incidence in individuals over age 50.
The National Colorectal Cancer Roundtable is leading the 80% by 2018 effort, saying that 1 in 3 adults between the ages of 50 and 75 years, or 23 million Americans, are not getting recommended screening.
Colorectal cancer is the third-leading cause of cancer death in the United States. In 2014, there will be an estimated 136,830 new diagnoses and 50,310 deaths. Sixty percent of the cases and 70% of the deaths are in those over age 65.
"Our goal today is absolutely clear: to eliminate colorectal cancer as a major public health threat," said Dr. Howard Koh, assistant secretary for health at the Health and Human Services department. HHS will be part of the campaign, along with state health departments; patient advocates; the American Association of Retired Persons (AARP); the American Cancer Society (ACS); and physician organizations, including the American College of Gastroenterology, the American College of Radiology, and the American Society for Gastrointestinal Endoscopy.
Dr. Koh spoke at a March 17 briefing sponsored by the ACS, which also published an analysis that day showing a decline in colorectal cancer incidence and mortality for most age groups, but for older Americans, in particular.
The study was published online in CA: A Cancer Journal for Clinicians, and was based on data from the Centers for Disease Control and Prevention’s National Center for Health Statistics; the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program; and the CDC’s National Program of Cancer Registries.
Overall, the incidence of colorectal cancer decreased by an average 3.4% per year from 2001 to 2010. The biggest declines were in people aged 50 years or older – at 3.9% per year, or a 30% decline over that decade. For people over age 65, the decline has been particularly notable—3.6% a year from 2001 to 2008 and 7.2% a year during 2008-2010.
The authors attribute that decline to a growth in screening. In 2000, 19% of Americans aged 50-75 years received some kind of screen. By 2010, the number had jumped to 55%.
"In other words, we are making real progress," said John R. Seffrin, chief executive officer of the ACS, at the briefing.
Some of the screening increase was due to Medicare coverage of all screening methods, including the fecal occult blood test, colonoscopy, and sigmoidoscopy. Sixty-four percent of Americans over age 65 had a screening test in 2010, compared with 55% of those in the 50- to 64-year-old group not covered by Medicare. Screening rates are highest in well-educated Americans who have health insurance, and in whites. Only a quarter of recent immigrants – those in the United States less than 10 years – were screened, compared with 62% of non-Hispanic whites. And only 18% of the uninsured had a screening exam in 2010, compared with 62% of those with insurance.
Just having insurance does not guarantee that screening will be cost-free, even though it is covered under Medicare and is an essential benefit under policies covered by the Affordable Care Act.
If polyps are found and removed, however, Medicare patients and others with private insurance often find themselves facing large copayments or lack of coverage for subsequent screenings. Gastroenterologists want to see an end to that "postpolypectomy surprise," said Dr. Ronald Vender, immediate past president of the American College of Gastroenterology, at the briefing.
The Removing Barriers to Colorectal Cancer Screening Act (H.R. 1070), which would cover any of those subsequent costs, was introduced in Congress in March 2013.
There are still major disparities in colorectal cancer incidence and mortality rates. Incidence and mortality rates are 30-40% higher in men than women. Incidence and mortality are highest in African Americans and lowest among Asian Pacific Islanders. From 2006 to 2010, the incidence in blacks was 25% higher than in whites and 50% higher than in Asian Pacific Islanders. Mortality rates are 50% higher for blacks than for whites, at 29.4 per 100,000. The higher incidence and mortality in blacks may be due to a lower socioeconomic status, but there are also other factors at play, said the authors, noting that rates are higher even for blacks in the same socioeconomic status as white peers.
Survival rates do not vary substantially by sex, according to the paper. While 5-year survival rates are relatively high – at 65% – only 40% of patients are diagnosed when the disease is localized. The 5-year survival at that stage is 90%.
But survival among blacks is the lowest among any race, 10% lower than for Asian Pacific Islanders, which have the best rates. Survival rates are lowest in high-poverty areas of America, including Appalachia and the mid-South, according to the ACS report.
On Twitter @aliciaault
WASHINGTON – Several dozen organizations have joined together to help increase colorectal cancer screening rates to 80% of all Americans by 2018, citing the success of campaigns over the past decade that led to a 30% decline in incidence in individuals over age 50.
The National Colorectal Cancer Roundtable is leading the 80% by 2018 effort, saying that 1 in 3 adults between the ages of 50 and 75 years, or 23 million Americans, are not getting recommended screening.
Colorectal cancer is the third-leading cause of cancer death in the United States. In 2014, there will be an estimated 136,830 new diagnoses and 50,310 deaths. Sixty percent of the cases and 70% of the deaths are in those over age 65.
"Our goal today is absolutely clear: to eliminate colorectal cancer as a major public health threat," said Dr. Howard Koh, assistant secretary for health at the Health and Human Services department. HHS will be part of the campaign, along with state health departments; patient advocates; the American Association of Retired Persons (AARP); the American Cancer Society (ACS); and physician organizations, including the American College of Gastroenterology, the American College of Radiology, and the American Society for Gastrointestinal Endoscopy.
Dr. Koh spoke at a March 17 briefing sponsored by the ACS, which also published an analysis that day showing a decline in colorectal cancer incidence and mortality for most age groups, but for older Americans, in particular.
The study was published online in CA: A Cancer Journal for Clinicians, and was based on data from the Centers for Disease Control and Prevention’s National Center for Health Statistics; the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program; and the CDC’s National Program of Cancer Registries.
Overall, the incidence of colorectal cancer decreased by an average 3.4% per year from 2001 to 2010. The biggest declines were in people aged 50 years or older – at 3.9% per year, or a 30% decline over that decade. For people over age 65, the decline has been particularly notable—3.6% a year from 2001 to 2008 and 7.2% a year during 2008-2010.
The authors attribute that decline to a growth in screening. In 2000, 19% of Americans aged 50-75 years received some kind of screen. By 2010, the number had jumped to 55%.
"In other words, we are making real progress," said John R. Seffrin, chief executive officer of the ACS, at the briefing.
Some of the screening increase was due to Medicare coverage of all screening methods, including the fecal occult blood test, colonoscopy, and sigmoidoscopy. Sixty-four percent of Americans over age 65 had a screening test in 2010, compared with 55% of those in the 50- to 64-year-old group not covered by Medicare. Screening rates are highest in well-educated Americans who have health insurance, and in whites. Only a quarter of recent immigrants – those in the United States less than 10 years – were screened, compared with 62% of non-Hispanic whites. And only 18% of the uninsured had a screening exam in 2010, compared with 62% of those with insurance.
Just having insurance does not guarantee that screening will be cost-free, even though it is covered under Medicare and is an essential benefit under policies covered by the Affordable Care Act.
If polyps are found and removed, however, Medicare patients and others with private insurance often find themselves facing large copayments or lack of coverage for subsequent screenings. Gastroenterologists want to see an end to that "postpolypectomy surprise," said Dr. Ronald Vender, immediate past president of the American College of Gastroenterology, at the briefing.
The Removing Barriers to Colorectal Cancer Screening Act (H.R. 1070), which would cover any of those subsequent costs, was introduced in Congress in March 2013.
There are still major disparities in colorectal cancer incidence and mortality rates. Incidence and mortality rates are 30-40% higher in men than women. Incidence and mortality are highest in African Americans and lowest among Asian Pacific Islanders. From 2006 to 2010, the incidence in blacks was 25% higher than in whites and 50% higher than in Asian Pacific Islanders. Mortality rates are 50% higher for blacks than for whites, at 29.4 per 100,000. The higher incidence and mortality in blacks may be due to a lower socioeconomic status, but there are also other factors at play, said the authors, noting that rates are higher even for blacks in the same socioeconomic status as white peers.
Survival rates do not vary substantially by sex, according to the paper. While 5-year survival rates are relatively high – at 65% – only 40% of patients are diagnosed when the disease is localized. The 5-year survival at that stage is 90%.
But survival among blacks is the lowest among any race, 10% lower than for Asian Pacific Islanders, which have the best rates. Survival rates are lowest in high-poverty areas of America, including Appalachia and the mid-South, according to the ACS report.
On Twitter @aliciaault
House passes bill to repeal the SGR
The House of Representatives on March 14 approved a bill to repeal the Medicare Sustainable Growth Rate formula; the Senate is not likely to take up the bill.
The House voted mostly along party lines, with 226 Republicans and 12 Democrats voting in favor of approving H.R. 4015 and sending it to the Senate. Many Democrats who voted against it objected to the bill’s financing, which was achieved through a 5-year delay of the Affordable Care Act’s individual health insurance mandate.
The Congressional Budget Office estimated that delaying the mandate would save about $170 billion over 10 years, while the Sustainable Growth Rate (SGR) fix would cost $130 billion in the same period. But the CBO also said that the plan would increase the number of uninsured by 13 million and lead to 10%-20% premium increases.
"Political games are threatening to derail months of bipartisan, bicameral progress" on implementing the Affordable Care Act, House Minority Leader Nancy Pelosi (D-Calif.) said in a speech before the vote.
"We shouldn’t be wasting time on this foolishness and this recklessness," she added, noting that securing a permanent fix before a 24% physician pay cut takes effect on April 1 was increasingly less likely as the Senate was not likely to approve the plan with the accompanying financing.
The House now is on break until March 25.
Dr. Ardis Dee Hoven, president of the American Medical Association, said that she was disappointed at the House action, given that the House and Senate had already agreed on the fundamentals of replacing the SGR. "It would be a shame for lawmakers to have done all of that hard work only to have it overcome by partisan politics over budgetary issues," she said in a statement.
"We thank all members who spoke on the floor in support of a return to bipartisan negotiations and encourage the United States Senate to proceed in a timely and bipartisan manner to advance legislation in that body," she said, adding that the AMA would continue to try to help forge a compromise.
"Continuing the cycle of kicking the can down the road through temporary patches in the months ahead simply wastes more taxpayer money to preserve a bad policy of Congress’ own making," Dr. Hoven said.
Leaders at other physicians’ organizations echoed Dr. Hoven’s disappointment.
"We’re dismayed that Congress sabotaged their own work by linking this legislation to unrelated, ideological issues – particularly in light of the nearly universal opposition to such action from patients, insurers, and the medical community," Dr. Reid Blackwelder, president of the American Academy of Family Physicians, said in a statement.
"It’s imperative that both parties come together to reach agreement on the budgetary payment that will pass both the House and the Senate before April 1," Dr. Blackwelder said.
Ms. Molly Cooke, president of the American College of Physicians, said the ACP stands by its statement from March 7. At that time, she said, "Congress knows that it is counterproductive for either the House or the Senate, Republicans or Democrats, to tie the bipartisan, bicameral SGR repeal bill to other policies that do not have the bipartisan support needed to pass both chambers, and be signed into law by the President."
Dr. Cooke added, "We cannot support linking SGR repeal to changes in current law that will result in fewer people getting health insurance coverage."
House Republican leaders called on the Senate to act.
"We have never come this far in finding a permanent solution," House Energy and Commerce Committee Chairman Fred Upton (R-Mich.) said in a statement. "But there is still much work to be done after today’s vote, and I call on my good friend Sen. Ron Wyden [D-Ore.] to pick up the torch and work with Majority Leader Harry Reid [D-Nev.] to put politics aside, stand up for our seniors and doctors, and solve SGR this year."
On Twitter @aliciaault
The House of Representatives on March 14 approved a bill to repeal the Medicare Sustainable Growth Rate formula; the Senate is not likely to take up the bill.
The House voted mostly along party lines, with 226 Republicans and 12 Democrats voting in favor of approving H.R. 4015 and sending it to the Senate. Many Democrats who voted against it objected to the bill’s financing, which was achieved through a 5-year delay of the Affordable Care Act’s individual health insurance mandate.
The Congressional Budget Office estimated that delaying the mandate would save about $170 billion over 10 years, while the Sustainable Growth Rate (SGR) fix would cost $130 billion in the same period. But the CBO also said that the plan would increase the number of uninsured by 13 million and lead to 10%-20% premium increases.
"Political games are threatening to derail months of bipartisan, bicameral progress" on implementing the Affordable Care Act, House Minority Leader Nancy Pelosi (D-Calif.) said in a speech before the vote.
"We shouldn’t be wasting time on this foolishness and this recklessness," she added, noting that securing a permanent fix before a 24% physician pay cut takes effect on April 1 was increasingly less likely as the Senate was not likely to approve the plan with the accompanying financing.
The House now is on break until March 25.
Dr. Ardis Dee Hoven, president of the American Medical Association, said that she was disappointed at the House action, given that the House and Senate had already agreed on the fundamentals of replacing the SGR. "It would be a shame for lawmakers to have done all of that hard work only to have it overcome by partisan politics over budgetary issues," she said in a statement.
"We thank all members who spoke on the floor in support of a return to bipartisan negotiations and encourage the United States Senate to proceed in a timely and bipartisan manner to advance legislation in that body," she said, adding that the AMA would continue to try to help forge a compromise.
"Continuing the cycle of kicking the can down the road through temporary patches in the months ahead simply wastes more taxpayer money to preserve a bad policy of Congress’ own making," Dr. Hoven said.
Leaders at other physicians’ organizations echoed Dr. Hoven’s disappointment.
"We’re dismayed that Congress sabotaged their own work by linking this legislation to unrelated, ideological issues – particularly in light of the nearly universal opposition to such action from patients, insurers, and the medical community," Dr. Reid Blackwelder, president of the American Academy of Family Physicians, said in a statement.
"It’s imperative that both parties come together to reach agreement on the budgetary payment that will pass both the House and the Senate before April 1," Dr. Blackwelder said.
Ms. Molly Cooke, president of the American College of Physicians, said the ACP stands by its statement from March 7. At that time, she said, "Congress knows that it is counterproductive for either the House or the Senate, Republicans or Democrats, to tie the bipartisan, bicameral SGR repeal bill to other policies that do not have the bipartisan support needed to pass both chambers, and be signed into law by the President."
Dr. Cooke added, "We cannot support linking SGR repeal to changes in current law that will result in fewer people getting health insurance coverage."
House Republican leaders called on the Senate to act.
"We have never come this far in finding a permanent solution," House Energy and Commerce Committee Chairman Fred Upton (R-Mich.) said in a statement. "But there is still much work to be done after today’s vote, and I call on my good friend Sen. Ron Wyden [D-Ore.] to pick up the torch and work with Majority Leader Harry Reid [D-Nev.] to put politics aside, stand up for our seniors and doctors, and solve SGR this year."
On Twitter @aliciaault
The House of Representatives on March 14 approved a bill to repeal the Medicare Sustainable Growth Rate formula; the Senate is not likely to take up the bill.
The House voted mostly along party lines, with 226 Republicans and 12 Democrats voting in favor of approving H.R. 4015 and sending it to the Senate. Many Democrats who voted against it objected to the bill’s financing, which was achieved through a 5-year delay of the Affordable Care Act’s individual health insurance mandate.
The Congressional Budget Office estimated that delaying the mandate would save about $170 billion over 10 years, while the Sustainable Growth Rate (SGR) fix would cost $130 billion in the same period. But the CBO also said that the plan would increase the number of uninsured by 13 million and lead to 10%-20% premium increases.
"Political games are threatening to derail months of bipartisan, bicameral progress" on implementing the Affordable Care Act, House Minority Leader Nancy Pelosi (D-Calif.) said in a speech before the vote.
"We shouldn’t be wasting time on this foolishness and this recklessness," she added, noting that securing a permanent fix before a 24% physician pay cut takes effect on April 1 was increasingly less likely as the Senate was not likely to approve the plan with the accompanying financing.
The House now is on break until March 25.
Dr. Ardis Dee Hoven, president of the American Medical Association, said that she was disappointed at the House action, given that the House and Senate had already agreed on the fundamentals of replacing the SGR. "It would be a shame for lawmakers to have done all of that hard work only to have it overcome by partisan politics over budgetary issues," she said in a statement.
"We thank all members who spoke on the floor in support of a return to bipartisan negotiations and encourage the United States Senate to proceed in a timely and bipartisan manner to advance legislation in that body," she said, adding that the AMA would continue to try to help forge a compromise.
"Continuing the cycle of kicking the can down the road through temporary patches in the months ahead simply wastes more taxpayer money to preserve a bad policy of Congress’ own making," Dr. Hoven said.
Leaders at other physicians’ organizations echoed Dr. Hoven’s disappointment.
"We’re dismayed that Congress sabotaged their own work by linking this legislation to unrelated, ideological issues – particularly in light of the nearly universal opposition to such action from patients, insurers, and the medical community," Dr. Reid Blackwelder, president of the American Academy of Family Physicians, said in a statement.
"It’s imperative that both parties come together to reach agreement on the budgetary payment that will pass both the House and the Senate before April 1," Dr. Blackwelder said.
Ms. Molly Cooke, president of the American College of Physicians, said the ACP stands by its statement from March 7. At that time, she said, "Congress knows that it is counterproductive for either the House or the Senate, Republicans or Democrats, to tie the bipartisan, bicameral SGR repeal bill to other policies that do not have the bipartisan support needed to pass both chambers, and be signed into law by the President."
Dr. Cooke added, "We cannot support linking SGR repeal to changes in current law that will result in fewer people getting health insurance coverage."
House Republican leaders called on the Senate to act.
"We have never come this far in finding a permanent solution," House Energy and Commerce Committee Chairman Fred Upton (R-Mich.) said in a statement. "But there is still much work to be done after today’s vote, and I call on my good friend Sen. Ron Wyden [D-Ore.] to pick up the torch and work with Majority Leader Harry Reid [D-Nev.] to put politics aside, stand up for our seniors and doctors, and solve SGR this year."
On Twitter @aliciaault
Cleveland Clinic first to get Joint Commission medical home certification
The Cleveland Clinic is the first health care provider to receive the Joint Commission’s Primary Care Medical Home certification.
The Joint Commission started its medical home certification option for hospitals in early 2013. The Cleveland Clinic is the first provider of any kind to receive the certification, according to the commission. It covers 39 practices at 29 Cleveland Clinic sites, involving 230 primary care physicians and advanced practice nurses.
"This certification recognizes our striving to be national leaders in population management and transformation of the care delivery model in the United States," said Dr. David L. Longworth, chair of the Medicine Institute at the Cleveland Clinic, in a statement.
To be certified by the Joint Commission, hospitals must already be accredited, and offer services from primary care clinicians – that can include physicians, nurse practitioners, and physician assistants. The hospitals are evaluated in five major areas: patient centeredness, comprehensiveness, coordinated care, access to care, and a systems-based approach to quality and safety. Patient centeredness, for instance, includes assessing a patient’s health literacy and including patients in their treatment plan. For access, a medical home has to provide care 24 hours a day, 7 days a week. In addition to urgent care, that can include clinical advice services by telephone.
The Cleveland Clinic had an on-site survey in September to determine if it met the parameters for certification.
The Joint Commission’s accreditation program is one of several aiming to give nationally recognized credentials to providers.
The National Committee on Quality Assurance (NCQA) has recognized about 7,000 primary care practices, encompassing almost 35,000 clinicians, as meeting its patient-centered medical home requirements. Thirty-seven states incorporate NCQA requirements into patient-centered medical home–related legislation, according to the organization. In late March, the NCQA will be unveiling updated medical home requirements.
The Accreditation Association for Ambulatory Health Care also offers medical home accreditation, as does URAC, which aligns its program with principles outlined by the major primary care societies.
On Twitter @aliciaault
The Cleveland Clinic is the first health care provider to receive the Joint Commission’s Primary Care Medical Home certification.
The Joint Commission started its medical home certification option for hospitals in early 2013. The Cleveland Clinic is the first provider of any kind to receive the certification, according to the commission. It covers 39 practices at 29 Cleveland Clinic sites, involving 230 primary care physicians and advanced practice nurses.
"This certification recognizes our striving to be national leaders in population management and transformation of the care delivery model in the United States," said Dr. David L. Longworth, chair of the Medicine Institute at the Cleveland Clinic, in a statement.
To be certified by the Joint Commission, hospitals must already be accredited, and offer services from primary care clinicians – that can include physicians, nurse practitioners, and physician assistants. The hospitals are evaluated in five major areas: patient centeredness, comprehensiveness, coordinated care, access to care, and a systems-based approach to quality and safety. Patient centeredness, for instance, includes assessing a patient’s health literacy and including patients in their treatment plan. For access, a medical home has to provide care 24 hours a day, 7 days a week. In addition to urgent care, that can include clinical advice services by telephone.
The Cleveland Clinic had an on-site survey in September to determine if it met the parameters for certification.
The Joint Commission’s accreditation program is one of several aiming to give nationally recognized credentials to providers.
The National Committee on Quality Assurance (NCQA) has recognized about 7,000 primary care practices, encompassing almost 35,000 clinicians, as meeting its patient-centered medical home requirements. Thirty-seven states incorporate NCQA requirements into patient-centered medical home–related legislation, according to the organization. In late March, the NCQA will be unveiling updated medical home requirements.
The Accreditation Association for Ambulatory Health Care also offers medical home accreditation, as does URAC, which aligns its program with principles outlined by the major primary care societies.
On Twitter @aliciaault
The Cleveland Clinic is the first health care provider to receive the Joint Commission’s Primary Care Medical Home certification.
The Joint Commission started its medical home certification option for hospitals in early 2013. The Cleveland Clinic is the first provider of any kind to receive the certification, according to the commission. It covers 39 practices at 29 Cleveland Clinic sites, involving 230 primary care physicians and advanced practice nurses.
"This certification recognizes our striving to be national leaders in population management and transformation of the care delivery model in the United States," said Dr. David L. Longworth, chair of the Medicine Institute at the Cleveland Clinic, in a statement.
To be certified by the Joint Commission, hospitals must already be accredited, and offer services from primary care clinicians – that can include physicians, nurse practitioners, and physician assistants. The hospitals are evaluated in five major areas: patient centeredness, comprehensiveness, coordinated care, access to care, and a systems-based approach to quality and safety. Patient centeredness, for instance, includes assessing a patient’s health literacy and including patients in their treatment plan. For access, a medical home has to provide care 24 hours a day, 7 days a week. In addition to urgent care, that can include clinical advice services by telephone.
The Cleveland Clinic had an on-site survey in September to determine if it met the parameters for certification.
The Joint Commission’s accreditation program is one of several aiming to give nationally recognized credentials to providers.
The National Committee on Quality Assurance (NCQA) has recognized about 7,000 primary care practices, encompassing almost 35,000 clinicians, as meeting its patient-centered medical home requirements. Thirty-seven states incorporate NCQA requirements into patient-centered medical home–related legislation, according to the organization. In late March, the NCQA will be unveiling updated medical home requirements.
The Accreditation Association for Ambulatory Health Care also offers medical home accreditation, as does URAC, which aligns its program with principles outlined by the major primary care societies.
On Twitter @aliciaault
CMS outlines how to get meaningful use exemptions
As promised, the Centers for Medicare & Medicaid Services has issued guidance on how physicians can apply for a hardship exemption on meeting Stage 2 of the meaningful use of electronic health records in 2014.
Administrator Marilyn Tavenner said at the annual meeting of the Healthcare Information and Management Systems Society on Feb. 27 that CMS would not extend the deadline for meeting Stage 2 criteria, but that it would allow more flexibility in how physicians and other eligible professionals reach the goals.
Physicians who participate in the meaningful use program receive incentive payments from Medicare. If they don’t participate this year, they’ll be penalized next year. On Feb. 21, 48 physician organizations wrote to the Health and Human Services department, asking for delays in some of the deadlines for meaningful use this year and for more flexibility from the CMS.
In a guidance document, the agency now says it is currently accepting applications for exemptions from penalties for 2015. Physicians who have not yet participated in meaningful use at all have until July 1 to apply.
If a physician has demonstrated meaningful use for the 2013 reporting year, there will be no penalty in 2015. If, however, a practice is having trouble implementing 2014 certified EHR technology for a 2014 reporting period, the practice or physician can apply for a hardship exception by July 1, 2015, to avoid a penalty in 2016.
Applications will be reviewed on a case-by-case basis, according to the guidance.
Meaningful use penalties only apply to physicians who participate in the Medicare incentive program, or in both the Medicare and Medicaid programs. There are no penalties for those who participate only in the Medicaid incentive program.
On Twitter @aliciaault
As promised, the Centers for Medicare & Medicaid Services has issued guidance on how physicians can apply for a hardship exemption on meeting Stage 2 of the meaningful use of electronic health records in 2014.
Administrator Marilyn Tavenner said at the annual meeting of the Healthcare Information and Management Systems Society on Feb. 27 that CMS would not extend the deadline for meeting Stage 2 criteria, but that it would allow more flexibility in how physicians and other eligible professionals reach the goals.
Physicians who participate in the meaningful use program receive incentive payments from Medicare. If they don’t participate this year, they’ll be penalized next year. On Feb. 21, 48 physician organizations wrote to the Health and Human Services department, asking for delays in some of the deadlines for meaningful use this year and for more flexibility from the CMS.
In a guidance document, the agency now says it is currently accepting applications for exemptions from penalties for 2015. Physicians who have not yet participated in meaningful use at all have until July 1 to apply.
If a physician has demonstrated meaningful use for the 2013 reporting year, there will be no penalty in 2015. If, however, a practice is having trouble implementing 2014 certified EHR technology for a 2014 reporting period, the practice or physician can apply for a hardship exception by July 1, 2015, to avoid a penalty in 2016.
Applications will be reviewed on a case-by-case basis, according to the guidance.
Meaningful use penalties only apply to physicians who participate in the Medicare incentive program, or in both the Medicare and Medicaid programs. There are no penalties for those who participate only in the Medicaid incentive program.
On Twitter @aliciaault
As promised, the Centers for Medicare & Medicaid Services has issued guidance on how physicians can apply for a hardship exemption on meeting Stage 2 of the meaningful use of electronic health records in 2014.
Administrator Marilyn Tavenner said at the annual meeting of the Healthcare Information and Management Systems Society on Feb. 27 that CMS would not extend the deadline for meeting Stage 2 criteria, but that it would allow more flexibility in how physicians and other eligible professionals reach the goals.
Physicians who participate in the meaningful use program receive incentive payments from Medicare. If they don’t participate this year, they’ll be penalized next year. On Feb. 21, 48 physician organizations wrote to the Health and Human Services department, asking for delays in some of the deadlines for meaningful use this year and for more flexibility from the CMS.
In a guidance document, the agency now says it is currently accepting applications for exemptions from penalties for 2015. Physicians who have not yet participated in meaningful use at all have until July 1 to apply.
If a physician has demonstrated meaningful use for the 2013 reporting year, there will be no penalty in 2015. If, however, a practice is having trouble implementing 2014 certified EHR technology for a 2014 reporting period, the practice or physician can apply for a hardship exception by July 1, 2015, to avoid a penalty in 2016.
Applications will be reviewed on a case-by-case basis, according to the guidance.
Meaningful use penalties only apply to physicians who participate in the Medicare incentive program, or in both the Medicare and Medicaid programs. There are no penalties for those who participate only in the Medicaid incentive program.
On Twitter @aliciaault
VIDEO: Bionic exoskeleton helps paralyzed patients walk
ORLANDO – It’s a bionic suit, a battery-powered exoskeleton, or as Chris Tagatac calls it, a wearable robot.
Mr. Tagatac, who is paralyzed from the lower ribs down, demonstrated the computer- and battery-operated Ekso Bionics suit at the annual meeting of the Healthcare Information and Management Systems Society, and he spoke with us about his experience. Watch the video to learn more about him and the technology.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On Twitter @aliciaault
On Twitter @naseemsmiller
ORLANDO – It’s a bionic suit, a battery-powered exoskeleton, or as Chris Tagatac calls it, a wearable robot.
Mr. Tagatac, who is paralyzed from the lower ribs down, demonstrated the computer- and battery-operated Ekso Bionics suit at the annual meeting of the Healthcare Information and Management Systems Society, and he spoke with us about his experience. Watch the video to learn more about him and the technology.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On Twitter @aliciaault
On Twitter @naseemsmiller
ORLANDO – It’s a bionic suit, a battery-powered exoskeleton, or as Chris Tagatac calls it, a wearable robot.
Mr. Tagatac, who is paralyzed from the lower ribs down, demonstrated the computer- and battery-operated Ekso Bionics suit at the annual meeting of the Healthcare Information and Management Systems Society, and he spoke with us about his experience. Watch the video to learn more about him and the technology.
The video associated with this article is no longer available on this site. Please view all of our videos on the MDedge YouTube channel
On Twitter @aliciaault
On Twitter @naseemsmiller
AT HIMSS14
MedPAC commissioners weigh extension of primary care pay bump
WASHINGTON – Primary care physicians should continue to receive a bump up in pay for their efforts, according to the Medicare Payment Advisory Commission.
At their March 6 meeting, MedPAC commissioners weighed potential options for extending a 10% pay increase for primary care physicians that was established by the Affordable Care Act and began in 2011. The increase is due to expire at the end of 2015.
MedPAC Chairman Glenn Hackbarth said that the panel is looking for ways to continue to attract more physicians to primary care. "We have too little primary care for the population that needs to be served," said Mr. Hackbarth. He said the commission wants to address that mismatch as quickly as possible.
The country should "expand the capacity of our existing primary care practices to care for bigger populations," Mr. Hackbarth said, adding that waiting for more physicians to be trained will take too long.
Currently, to be eligible for the quarterly payments, primary care physicians have to show that at least 60% of their total Medicare allowed charges come from Current Procedural Terminology (CPT) codes 99201-99215 (for office and other outpatient visits).
In 2011, the Centers for Medicare and Medicaid Services (CMS) paid $560 million in bonuses, and in 2012, the agency paid $664 million in bonuses to 194,428 family physicians, internists, pediatricians, geriatricians, nurse practitioners, and physician assistants.
MedPAC wants to revamp the payment scheme in part because it’s based on the fee-for-service system. "It’s about changing what qualifies as productivity for payment," said Mr. Hackbarth.
Instead, the commission is considering a per-beneficiary payment that would acknowledge all of the intangibles that go with primary care, including care coordination, afterhours access, and non–face-to-face interactions, Mr. Hackbarth said.
MedPAC staff suggested several funding options. One would be to reduce payments for almost all services covered by the Physician Fee Schedule by about 1%. That would allow for a monthly per-beneficiary payment of about $2.60 a month.
Another option would be to reduce Medicare payments for services provided by specialists by 1.4%; that would provide the same $2.60 a month payment.
MedPAC staff also floated the idea of identifying and reducing payments for overpriced services. The CMS is currently evaluating many overpriced services, and the American Medical Association’s Relative Value Update Committee (RUC) has subsequently reduced time estimates and values for many of them. But the reductions in time and work values have not been proportionate, which means some services are still likely overvalued, said MedPAC staffer Kevin Hayes.
He estimated that targeting more of the overpriced services could allow a per-beneficiary pay boost to continue for 5 years, rising from $2.60 a month in the first year to $13 in the final year.
MedPAC meets again in April and submits its report to Congress in June. The next report will likely contain its final recommendations on the primary care incentive payment program.
[email protected] On Twitter @aliciaault
WASHINGTON – Primary care physicians should continue to receive a bump up in pay for their efforts, according to the Medicare Payment Advisory Commission.
At their March 6 meeting, MedPAC commissioners weighed potential options for extending a 10% pay increase for primary care physicians that was established by the Affordable Care Act and began in 2011. The increase is due to expire at the end of 2015.
MedPAC Chairman Glenn Hackbarth said that the panel is looking for ways to continue to attract more physicians to primary care. "We have too little primary care for the population that needs to be served," said Mr. Hackbarth. He said the commission wants to address that mismatch as quickly as possible.
The country should "expand the capacity of our existing primary care practices to care for bigger populations," Mr. Hackbarth said, adding that waiting for more physicians to be trained will take too long.
Currently, to be eligible for the quarterly payments, primary care physicians have to show that at least 60% of their total Medicare allowed charges come from Current Procedural Terminology (CPT) codes 99201-99215 (for office and other outpatient visits).
In 2011, the Centers for Medicare and Medicaid Services (CMS) paid $560 million in bonuses, and in 2012, the agency paid $664 million in bonuses to 194,428 family physicians, internists, pediatricians, geriatricians, nurse practitioners, and physician assistants.
MedPAC wants to revamp the payment scheme in part because it’s based on the fee-for-service system. "It’s about changing what qualifies as productivity for payment," said Mr. Hackbarth.
Instead, the commission is considering a per-beneficiary payment that would acknowledge all of the intangibles that go with primary care, including care coordination, afterhours access, and non–face-to-face interactions, Mr. Hackbarth said.
MedPAC staff suggested several funding options. One would be to reduce payments for almost all services covered by the Physician Fee Schedule by about 1%. That would allow for a monthly per-beneficiary payment of about $2.60 a month.
Another option would be to reduce Medicare payments for services provided by specialists by 1.4%; that would provide the same $2.60 a month payment.
MedPAC staff also floated the idea of identifying and reducing payments for overpriced services. The CMS is currently evaluating many overpriced services, and the American Medical Association’s Relative Value Update Committee (RUC) has subsequently reduced time estimates and values for many of them. But the reductions in time and work values have not been proportionate, which means some services are still likely overvalued, said MedPAC staffer Kevin Hayes.
He estimated that targeting more of the overpriced services could allow a per-beneficiary pay boost to continue for 5 years, rising from $2.60 a month in the first year to $13 in the final year.
MedPAC meets again in April and submits its report to Congress in June. The next report will likely contain its final recommendations on the primary care incentive payment program.
[email protected] On Twitter @aliciaault
WASHINGTON – Primary care physicians should continue to receive a bump up in pay for their efforts, according to the Medicare Payment Advisory Commission.
At their March 6 meeting, MedPAC commissioners weighed potential options for extending a 10% pay increase for primary care physicians that was established by the Affordable Care Act and began in 2011. The increase is due to expire at the end of 2015.
MedPAC Chairman Glenn Hackbarth said that the panel is looking for ways to continue to attract more physicians to primary care. "We have too little primary care for the population that needs to be served," said Mr. Hackbarth. He said the commission wants to address that mismatch as quickly as possible.
The country should "expand the capacity of our existing primary care practices to care for bigger populations," Mr. Hackbarth said, adding that waiting for more physicians to be trained will take too long.
Currently, to be eligible for the quarterly payments, primary care physicians have to show that at least 60% of their total Medicare allowed charges come from Current Procedural Terminology (CPT) codes 99201-99215 (for office and other outpatient visits).
In 2011, the Centers for Medicare and Medicaid Services (CMS) paid $560 million in bonuses, and in 2012, the agency paid $664 million in bonuses to 194,428 family physicians, internists, pediatricians, geriatricians, nurse practitioners, and physician assistants.
MedPAC wants to revamp the payment scheme in part because it’s based on the fee-for-service system. "It’s about changing what qualifies as productivity for payment," said Mr. Hackbarth.
Instead, the commission is considering a per-beneficiary payment that would acknowledge all of the intangibles that go with primary care, including care coordination, afterhours access, and non–face-to-face interactions, Mr. Hackbarth said.
MedPAC staff suggested several funding options. One would be to reduce payments for almost all services covered by the Physician Fee Schedule by about 1%. That would allow for a monthly per-beneficiary payment of about $2.60 a month.
Another option would be to reduce Medicare payments for services provided by specialists by 1.4%; that would provide the same $2.60 a month payment.
MedPAC staff also floated the idea of identifying and reducing payments for overpriced services. The CMS is currently evaluating many overpriced services, and the American Medical Association’s Relative Value Update Committee (RUC) has subsequently reduced time estimates and values for many of them. But the reductions in time and work values have not been proportionate, which means some services are still likely overvalued, said MedPAC staffer Kevin Hayes.
He estimated that targeting more of the overpriced services could allow a per-beneficiary pay boost to continue for 5 years, rising from $2.60 a month in the first year to $13 in the final year.
MedPAC meets again in April and submits its report to Congress in June. The next report will likely contain its final recommendations on the primary care incentive payment program.
[email protected] On Twitter @aliciaault
AT A MEDPAC MEETING
