Jane Anderson

Adverse Event Reporting Criticized

Little information is made public about adverse events in hospitals, even though public disclosure can help clinicians improve patient safety, according to a government report. After reviewing 8 federally approved patient safety organizations and 17 systems that collect adverse event information for states, the Department of Health and Human Services Inspector General found that only 7 state systems passed along to providers adverse event analyses that led to changes in practice. The other states passed along reports without any analysis. A nationwide database of adverse events collected by the patient safety organizations won't be operational until at least 2011, the report said.

Tobacco Act Takes a Hit

A federal district court has struck down parts of the Family Smoking Prevention and Tobacco Control Act of 2009, saying that some of the landmark law violates tobacco makers' free speech rights. The U.S. District Court for the Western District of Kentucky ruled it unconstitutional to ban color and images in tobacco advertising. But the court upheld provisions requiring large, strongly worded warnings on tobacco packaging, prohibiting companies from making health claims about tobacco products without Food and Drug Administration review, and banning tobacco-branded events and merchandise, such as T-shirts. American Thoracic Society president Dr. J.R. Curtis said in a statement that the society is “confident that the FDA will exercise its new authority to reduce tobacco use in the U.S. by stopping the efforts of big tobacco to market its dangerous products to minors, and by giving current smokers more motivation to stop smoking.”

New York Limits Its Salt

The New York City Health Department said it will ask restaurants and producers of packaged food to voluntarily reduce sodium in their meals and products by 25% over 5 years in an effort to curb high blood pressure and heart disease. The department acted as leader of the National Salt Reduction Initiative, a partnership of cities, states, and health organizations. The New York agency said that nearly 80% of the sodium in Americans' diets is added to foods before they are sold. After a year of consultation with food industry leaders, the coalition has developed targets for salt reductions in various foods. In a statement following the New York announcement, Centers for Disease Control and Prevention director Dr. Thomas Frieden endorsed such efforts: “The majority of Americans are consuming about twice the recommended limit of sodium each day, and not by choice. Achieving substantial reductions in sodium levels by incremental decreases in sodium content across the food supply can save many lives while maintaining good taste.”

Few Drug-Safety Data Are Online

Safety and efficacy information collected as part of the federal drug approval process is not available online for 9 of the top 25 prescribed brand-name drugs in the United States, according to the Sunlight Foundation, which advocates for transparency in government. The foundation's report found that the FDA makes background documents available online only for drugs approved since 1997. Information for drugs approved earlier is online only in response to a formal request. Safety and efficacy information for Lipitor (atorvastatin), Plavix (clopidogrel), and Synthroid (levothroxine) is not available online, according to the foundation. In addition, the information that is online is in a format that's difficult for researchers and the public to use, according to the report.

FDA Okayed 26 Meds in 2009

The FDA approved 19 new chemical entities and 7 new biologic agents in 2009, according to Washington Analysis, a Washington, D.C.–based investment adviser. Among the new biologics were Medicis's injectable wrinkle fighter Dysport. In the report, Washington Analysis's Ira Loss said he had expected more approvals last year because the agency claimed it wouldn't let statutory approval dates be overridden and it received more money for reviews. In 2008, the FDA approved 21 new chemical entities and 4 new biologics, the report said.

CMS Launches Provider Survey

The Centers for Medicare and Medicaid Services kicked off its fifth annual survey to determine provider satisfaction with Medicare fee-for-service contractors. The contractors process and pay more than $370 billion in Medicare claims each year. The Medicare Contractor Provider Satisfaction Survey offers physicians and other providers a chance to say how well their contractor handles inquiries, outreach, education, claims processing, appeals, reviews, and audits. The CMS said it is sending the 2010 survey to approximately 30,000 randomly selected providers, including practitioners, suppliers, and institutions. Participants can submit their responses confidentially online or via mail, fax, or telephone, the CMS said. Results of the survey, which will take several months to complete, will be released on the CMS Web site this summer, the agency said.

Adverse Event Reporting Criticized

Little information is made public about adverse events in hospitals, even though public disclosure can help clinicians improve patient safety, according to a government report. After reviewing 8 federally approved patient safety organizations and 17 systems that collect adverse event information for states, the Department of Health and Human Services Inspector General found that only 7 state systems passed along to providers adverse event analyses that led to changes in practice. The other states passed along reports without any analysis. A nationwide database of adverse events collected by the patient safety organizations won't be operational until at least 2011, the report said.

Tobacco Act Takes a Hit

A federal district court has struck down parts of the Family Smoking Prevention and Tobacco Control Act of 2009, saying that some of the landmark law violates tobacco makers' free speech rights. The U.S. District Court for the Western District of Kentucky ruled it unconstitutional to ban color and images in tobacco advertising. But the court upheld provisions requiring large, strongly worded warnings on tobacco packaging, prohibiting companies from making health claims about tobacco products without Food and Drug Administration review, and banning tobacco-branded events and merchandise, such as T-shirts. American Thoracic Society president Dr. J.R. Curtis said in a statement that the society is “confident that the FDA will exercise its new authority to reduce tobacco use in the U.S. by stopping the efforts of big tobacco to market its dangerous products to minors, and by giving current smokers more motivation to stop smoking.”

New York Limits Its Salt

The New York City Health Department said it will ask restaurants and producers of packaged food to voluntarily reduce sodium in their meals and products by 25% over 5 years in an effort to curb high blood pressure and heart disease. The department acted as leader of the National Salt Reduction Initiative, a partnership of cities, states, and health organizations. The New York agency said that nearly 80% of the sodium in Americans' diets is added to foods before they are sold. After a year of consultation with food industry leaders, the coalition has developed targets for salt reductions in various foods. In a statement following the New York announcement, Centers for Disease Control and Prevention director Dr. Thomas Frieden endorsed such efforts: “The majority of Americans are consuming about twice the recommended limit of sodium each day, and not by choice. Achieving substantial reductions in sodium levels by incremental decreases in sodium content across the food supply can save many lives while maintaining good taste.”

Few Drug-Safety Data Are Online

Safety and efficacy information collected as part of the federal drug approval process is not available online for 9 of the top 25 prescribed brand-name drugs in the United States, according to the Sunlight Foundation, which advocates for transparency in government. The foundation's report found that the FDA makes background documents available online only for drugs approved since 1997. Information for drugs approved earlier is online only in response to a formal request. Safety and efficacy information for Lipitor (atorvastatin), Plavix (clopidogrel), and Synthroid (levothroxine) is not available online, according to the foundation. In addition, the information that is online is in a format that's difficult for researchers and the public to use, according to the report.

FDA Okayed 26 Meds in 2009

The FDA approved 19 new chemical entities and 7 new biologic agents in 2009, according to Washington Analysis, a Washington, D.C.–based investment adviser. Among the new biologics were Medicis's injectable wrinkle fighter Dysport. In the report, Washington Analysis's Ira Loss said he had expected more approvals last year because the agency claimed it wouldn't let statutory approval dates be overridden and it received more money for reviews. In 2008, the FDA approved 21 new chemical entities and 4 new biologics, the report said.

CMS Launches Provider Survey

The Centers for Medicare and Medicaid Services kicked off its fifth annual survey to determine provider satisfaction with Medicare fee-for-service contractors. The contractors process and pay more than $370 billion in Medicare claims each year. The Medicare Contractor Provider Satisfaction Survey offers physicians and other providers a chance to say how well their contractor handles inquiries, outreach, education, claims processing, appeals, reviews, and audits. The CMS said it is sending the 2010 survey to approximately 30,000 randomly selected providers, including practitioners, suppliers, and institutions. Participants can submit their responses confidentially online or via mail, fax, or telephone, the CMS said. Results of the survey, which will take several months to complete, will be released on the CMS Web site this summer, the agency said.

Adverse Event Reporting Criticized

Little information is made public about adverse events in hospitals, even though public disclosure can help clinicians improve patient safety, according to a government report. After reviewing 8 federally approved patient safety organizations and 17 systems that collect adverse event information for states, the Department of Health and Human Services Inspector General found that only 7 state systems passed along to providers adverse event analyses that led to changes in practice. The other states passed along reports without any analysis. A nationwide database of adverse events collected by the patient safety organizations won't be operational until at least 2011, the report said.

Tobacco Act Takes a Hit

A federal district court has struck down parts of the Family Smoking Prevention and Tobacco Control Act of 2009, saying that some of the landmark law violates tobacco makers' free speech rights. The U.S. District Court for the Western District of Kentucky ruled it unconstitutional to ban color and images in tobacco advertising. But the court upheld provisions requiring large, strongly worded warnings on tobacco packaging, prohibiting companies from making health claims about tobacco products without Food and Drug Administration review, and banning tobacco-branded events and merchandise, such as T-shirts. American Thoracic Society president Dr. J.R. Curtis said in a statement that the society is “confident that the FDA will exercise its new authority to reduce tobacco use in the U.S. by stopping the efforts of big tobacco to market its dangerous products to minors, and by giving current smokers more motivation to stop smoking.”

New York Limits Its Salt

The New York City Health Department said it will ask restaurants and producers of packaged food to voluntarily reduce sodium in their meals and products by 25% over 5 years in an effort to curb high blood pressure and heart disease. The department acted as leader of the National Salt Reduction Initiative, a partnership of cities, states, and health organizations. The New York agency said that nearly 80% of the sodium in Americans' diets is added to foods before they are sold. After a year of consultation with food industry leaders, the coalition has developed targets for salt reductions in various foods. In a statement following the New York announcement, Centers for Disease Control and Prevention director Dr. Thomas Frieden endorsed such efforts: “The majority of Americans are consuming about twice the recommended limit of sodium each day, and not by choice. Achieving substantial reductions in sodium levels by incremental decreases in sodium content across the food supply can save many lives while maintaining good taste.”

Few Drug-Safety Data Are Online

Safety and efficacy information collected as part of the federal drug approval process is not available online for 9 of the top 25 prescribed brand-name drugs in the United States, according to the Sunlight Foundation, which advocates for transparency in government. The foundation's report found that the FDA makes background documents available online only for drugs approved since 1997. Information for drugs approved earlier is online only in response to a formal request. Safety and efficacy information for Lipitor (atorvastatin), Plavix (clopidogrel), and Synthroid (levothroxine) is not available online, according to the foundation. In addition, the information that is online is in a format that's difficult for researchers and the public to use, according to the report.

FDA Okayed 26 Meds in 2009

The FDA approved 19 new chemical entities and 7 new biologic agents in 2009, according to Washington Analysis, a Washington, D.C.–based investment adviser. Among the new biologics were Medicis's injectable wrinkle fighter Dysport. In the report, Washington Analysis's Ira Loss said he had expected more approvals last year because the agency claimed it wouldn't let statutory approval dates be overridden and it received more money for reviews. In 2008, the FDA approved 21 new chemical entities and 4 new biologics, the report said.

CMS Launches Provider Survey

The Centers for Medicare and Medicaid Services kicked off its fifth annual survey to determine provider satisfaction with Medicare fee-for-service contractors. The contractors process and pay more than $370 billion in Medicare claims each year. The Medicare Contractor Provider Satisfaction Survey offers physicians and other providers a chance to say how well their contractor handles inquiries, outreach, education, claims processing, appeals, reviews, and audits. The CMS said it is sending the 2010 survey to approximately 30,000 randomly selected providers, including practitioners, suppliers, and institutions. Participants can submit their responses confidentially online or via mail, fax, or telephone, the CMS said. Results of the survey, which will take several months to complete, will be released on the CMS Web site this summer, the agency said.

The United States lags behind other countries in adopting health information technology, providing financial incentives for quality, and improving overall access to care, according to a survey of primary care physicians in 11 countries.

These deficits have led to lesser quality of care in the United States in several areas compared with other countries, Commonwealth Fund President Karen Davis, Ph.D., said in announcing the results of her organization's International Health Policy Survey.

“Our weak primary care system puts patients at risk and results in poor health outcomes and higher costs,” Ms. Davis said during a teleconference.

The survey, results of which were published online in the journal Health Affairs (2009;28:w1171-83), found that 58% of U.S. primary care physicians said their patients often have difficulty paying for medications and care, compared with 5%-37% of patients in the other countries studied.

In addition, 71% of U.S. physicians reported that their practices do not have provisions for after-hours care, forcing patients to seek care in emergency departments. At least half of physicians in all but two of the countries studied (Norway and Canada) said they have provisions for after-hours care.

U.S. physicians were far less likely than were their international peers to use HIT—only 46% of U.S. doctors use electronic medical records, compared with 99% of physicians in the Netherlands and 97% of physicians in New Zealand and Norway, the survey showed.

Insurance restrictions on medications and treatment for patients pose major time concerns for 48% of physicians in the United States. While 42% of physicians in Italy and 34% of physicians in Germany reported similar problems, fewer than 20% of physicians in other countries said insurance restrictions were a major time concern.

The survey did find that in the United States, access to specialists is superior compared with almost all the other countries; only the United Kingdom, where 22% of primary care physicians reported that their patients often experience long waits to see specialists, scored higher. In comparison, 28% of U.S. physicians reported long waits. In other countries, notably Italy and Canada, up to three-fourths of primary care physicians reported waiting times for their patients to access specialists.

Many of the areas in which the United States lags behind would be addressed by health reform legislation being considered by Congress, said Commonwealth Fund Senior Vice President Cathy Schoen, lead author of the study. She noted that other countries have strong national policies to support primary care and HIT.

“These findings are particularly notable when you look at how much countries are spending per person,” said Ms. Schoen. “The [United States] is by far the most expensive country in this survey, and the gap has been growing without a return in value.”

Meanwhile, other countries are jumping ahead in implementing the patient-centered medical home approach, she said. “The concept … originated in the United States, but we found that such efforts are spreading faster in other countries,” Ms. Schoen said.

All but two other countries provide a greater percentage of physicians with financial incentives for providing needed chronic or preventive care services or implementing other aspects of the medical home model, the survey showed.

Such financial incentives should not be based on volume, but rather on rewarding physicians who provide a medical home and excellent chronic care management, Ms. Schoen said. Access to care is equally important, she added. “We can't hold doctors accountable, if patients can't afford to pay for care.”

For the study, Commonwealth Fund authors surveyed more than 10,000 primary care physicians in Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, the United Kingdom, and the United States. Data were collected from February through July 2009.

The United States lags behind other countries in adopting health information technology, providing financial incentives for quality, and improving overall access to care, according to a survey of primary care physicians in 11 countries.

These deficits have led to lesser quality of care in the United States in several areas compared with other countries, Commonwealth Fund President Karen Davis, Ph.D., said in announcing the results of her organization's International Health Policy Survey.

“Our weak primary care system puts patients at risk and results in poor health outcomes and higher costs,” Ms. Davis said during a teleconference.

The survey, results of which were published online in the journal Health Affairs (2009;28:w1171-83), found that 58% of U.S. primary care physicians said their patients often have difficulty paying for medications and care, compared with 5%-37% of patients in the other countries studied.

In addition, 71% of U.S. physicians reported that their practices do not have provisions for after-hours care, forcing patients to seek care in emergency departments. At least half of physicians in all but two of the countries studied (Norway and Canada) said they have provisions for after-hours care.

U.S. physicians were far less likely than were their international peers to use HIT—only 46% of U.S. doctors use electronic medical records, compared with 99% of physicians in the Netherlands and 97% of physicians in New Zealand and Norway, the survey showed.

Insurance restrictions on medications and treatment for patients pose major time concerns for 48% of physicians in the United States. While 42% of physicians in Italy and 34% of physicians in Germany reported similar problems, fewer than 20% of physicians in other countries said insurance restrictions were a major time concern.

The survey did find that in the United States, access to specialists is superior compared with almost all the other countries; only the United Kingdom, where 22% of primary care physicians reported that their patients often experience long waits to see specialists, scored higher. In comparison, 28% of U.S. physicians reported long waits. In other countries, notably Italy and Canada, up to three-fourths of primary care physicians reported waiting times for their patients to access specialists.

Many of the areas in which the United States lags behind would be addressed by health reform legislation being considered by Congress, said Commonwealth Fund Senior Vice President Cathy Schoen, lead author of the study. She noted that other countries have strong national policies to support primary care and HIT.

“These findings are particularly notable when you look at how much countries are spending per person,” said Ms. Schoen. “The [United States] is by far the most expensive country in this survey, and the gap has been growing without a return in value.”

Meanwhile, other countries are jumping ahead in implementing the patient-centered medical home approach, she said. “The concept … originated in the United States, but we found that such efforts are spreading faster in other countries,” Ms. Schoen said.

All but two other countries provide a greater percentage of physicians with financial incentives for providing needed chronic or preventive care services or implementing other aspects of the medical home model, the survey showed.

Such financial incentives should not be based on volume, but rather on rewarding physicians who provide a medical home and excellent chronic care management, Ms. Schoen said. Access to care is equally important, she added. “We can't hold doctors accountable, if patients can't afford to pay for care.”

For the study, Commonwealth Fund authors surveyed more than 10,000 primary care physicians in Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, the United Kingdom, and the United States. Data were collected from February through July 2009.

The United States lags behind other countries in adopting health information technology, providing financial incentives for quality, and improving overall access to care, according to a survey of primary care physicians in 11 countries.

These deficits have led to lesser quality of care in the United States in several areas compared with other countries, Commonwealth Fund President Karen Davis, Ph.D., said in announcing the results of her organization's International Health Policy Survey.

“Our weak primary care system puts patients at risk and results in poor health outcomes and higher costs,” Ms. Davis said during a teleconference.

The survey, results of which were published online in the journal Health Affairs (2009;28:w1171-83), found that 58% of U.S. primary care physicians said their patients often have difficulty paying for medications and care, compared with 5%-37% of patients in the other countries studied.

In addition, 71% of U.S. physicians reported that their practices do not have provisions for after-hours care, forcing patients to seek care in emergency departments. At least half of physicians in all but two of the countries studied (Norway and Canada) said they have provisions for after-hours care.

U.S. physicians were far less likely than were their international peers to use HIT—only 46% of U.S. doctors use electronic medical records, compared with 99% of physicians in the Netherlands and 97% of physicians in New Zealand and Norway, the survey showed.

Insurance restrictions on medications and treatment for patients pose major time concerns for 48% of physicians in the United States. While 42% of physicians in Italy and 34% of physicians in Germany reported similar problems, fewer than 20% of physicians in other countries said insurance restrictions were a major time concern.

The survey did find that in the United States, access to specialists is superior compared with almost all the other countries; only the United Kingdom, where 22% of primary care physicians reported that their patients often experience long waits to see specialists, scored higher. In comparison, 28% of U.S. physicians reported long waits. In other countries, notably Italy and Canada, up to three-fourths of primary care physicians reported waiting times for their patients to access specialists.

Many of the areas in which the United States lags behind would be addressed by health reform legislation being considered by Congress, said Commonwealth Fund Senior Vice President Cathy Schoen, lead author of the study. She noted that other countries have strong national policies to support primary care and HIT.

“These findings are particularly notable when you look at how much countries are spending per person,” said Ms. Schoen. “The [United States] is by far the most expensive country in this survey, and the gap has been growing without a return in value.”

Meanwhile, other countries are jumping ahead in implementing the patient-centered medical home approach, she said. “The concept … originated in the United States, but we found that such efforts are spreading faster in other countries,” Ms. Schoen said.

All but two other countries provide a greater percentage of physicians with financial incentives for providing needed chronic or preventive care services or implementing other aspects of the medical home model, the survey showed.

Such financial incentives should not be based on volume, but rather on rewarding physicians who provide a medical home and excellent chronic care management, Ms. Schoen said. Access to care is equally important, she added. “We can't hold doctors accountable, if patients can't afford to pay for care.”

For the study, Commonwealth Fund authors surveyed more than 10,000 primary care physicians in Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, the United Kingdom, and the United States. Data were collected from February through July 2009.

The United States lags behind other countries in terms of adoption of health information technology, providing financial incentives for quality, and improving overall access to care, according to findings from a survey of primary care physicians in 11 countries.

These deficits in primary care, health information technology (HIT), and access have led to lesser quality of care in the United States in several areas compared with other countries, Common wealth Fund President Karen Davis, Ph.D., said in announcing the results of her organization's International Health Policy Survey.

“Our weak primary care system puts patients at risk and results in poor health outcomes and higher costs,” Ms. Davis said during a teleconference.

The survey of more than 10,000 primary care physicians, results of which were published online in Health Affairs (2009;28:w1171-83), found that 58% of U.S. physicians said their patients often have difficulty paying for medications and care, compared with 5%-37% of patients in the 10 other countries studied.

In addition, 71% of U.S. physicians reported that their practices do not have provisions for after-hours care, forcing patients to seek care in emergency departments, the survey showed.

Of the other countries studied, at least half of physicians in all but two countries (Norway and Canada) said they have provisions for after-hours care.

U.S. physicians also were far less likely than their international peers to use HIT—only 46% of U.S. doctors use electronic medical records, compared with 99% of physicians in the Netherlands and 97% of physicians in New Zealand and Norway, the survey showed.

And, insurance restrictions on medications and treatment for patients pose major time concerns for 48% of physicians in the United States, the survey found.

While 42% of physicians in Italy and 34% of physicians in Germany reported similar problems, fewer than 20% of physicians in other countries said insurance restrictions were a major time concern.

The survey did find that in the United States, access to specialists is superior compared with almost all the other countries; only the United Kingdom, where 22% of primary care physicians reported that their patients often experience long waits to see specialists, scored higher.

In comparison, 28% of U.S. physicians reported long waits.

In other countries, notably Italy and Canada, up to three-fourths of primary care physicians reported waiting times for their patients to access specialists.

Many of the areas in which the United States lags behind other countries would be addressed by health reform legislation currently being considered by Congress, commented Commonwealth Fund Senior Vice President Cathy Schoen, lead author of the study.

She noted that other countries have strong national policies to support primary care and HIT.

“These findings are particularly notable when you look at how much countries are spending per person,” said Ms. Schoen.

“The [United States] is by far the most expensive country in this survey, and the gap has been growing without a return in value.”

Meanwhile, other countries are jumping ahead in implementing the patient-centered medical home approach, she said.

“The concept … originated in the United States, but we found that such efforts are spreading faster in other countries,” Ms. Schoen said.

For example, all but two other countries provide a greater percentage of physicians with financial incentives for providing needed chronic or preventive care services or implementing other aspects of the medical home model, the survey showed.

The United States lags behind other countries in terms of adoption of health information technology, providing financial incentives for quality, and improving overall access to care, according to findings from a survey of primary care physicians in 11 countries.

These deficits in primary care, health information technology (HIT), and access have led to lesser quality of care in the United States in several areas compared with other countries, Common wealth Fund President Karen Davis, Ph.D., said in announcing the results of her organization's International Health Policy Survey.

“Our weak primary care system puts patients at risk and results in poor health outcomes and higher costs,” Ms. Davis said during a teleconference.

The survey of more than 10,000 primary care physicians, results of which were published online in Health Affairs (2009;28:w1171-83), found that 58% of U.S. physicians said their patients often have difficulty paying for medications and care, compared with 5%-37% of patients in the 10 other countries studied.

In addition, 71% of U.S. physicians reported that their practices do not have provisions for after-hours care, forcing patients to seek care in emergency departments, the survey showed.

Of the other countries studied, at least half of physicians in all but two countries (Norway and Canada) said they have provisions for after-hours care.

U.S. physicians also were far less likely than their international peers to use HIT—only 46% of U.S. doctors use electronic medical records, compared with 99% of physicians in the Netherlands and 97% of physicians in New Zealand and Norway, the survey showed.

And, insurance restrictions on medications and treatment for patients pose major time concerns for 48% of physicians in the United States, the survey found.

While 42% of physicians in Italy and 34% of physicians in Germany reported similar problems, fewer than 20% of physicians in other countries said insurance restrictions were a major time concern.

The survey did find that in the United States, access to specialists is superior compared with almost all the other countries; only the United Kingdom, where 22% of primary care physicians reported that their patients often experience long waits to see specialists, scored higher.

In comparison, 28% of U.S. physicians reported long waits.

In other countries, notably Italy and Canada, up to three-fourths of primary care physicians reported waiting times for their patients to access specialists.

Many of the areas in which the United States lags behind other countries would be addressed by health reform legislation currently being considered by Congress, commented Commonwealth Fund Senior Vice President Cathy Schoen, lead author of the study.

She noted that other countries have strong national policies to support primary care and HIT.

“These findings are particularly notable when you look at how much countries are spending per person,” said Ms. Schoen.

“The [United States] is by far the most expensive country in this survey, and the gap has been growing without a return in value.”

Meanwhile, other countries are jumping ahead in implementing the patient-centered medical home approach, she said.

“The concept … originated in the United States, but we found that such efforts are spreading faster in other countries,” Ms. Schoen said.

For example, all but two other countries provide a greater percentage of physicians with financial incentives for providing needed chronic or preventive care services or implementing other aspects of the medical home model, the survey showed.

The United States lags behind other countries in terms of adoption of health information technology, providing financial incentives for quality, and improving overall access to care, according to findings from a survey of primary care physicians in 11 countries.

These deficits in primary care, health information technology (HIT), and access have led to lesser quality of care in the United States in several areas compared with other countries, Common wealth Fund President Karen Davis, Ph.D., said in announcing the results of her organization's International Health Policy Survey.

“Our weak primary care system puts patients at risk and results in poor health outcomes and higher costs,” Ms. Davis said during a teleconference.

The survey of more than 10,000 primary care physicians, results of which were published online in Health Affairs (2009;28:w1171-83), found that 58% of U.S. physicians said their patients often have difficulty paying for medications and care, compared with 5%-37% of patients in the 10 other countries studied.

In addition, 71% of U.S. physicians reported that their practices do not have provisions for after-hours care, forcing patients to seek care in emergency departments, the survey showed.

Of the other countries studied, at least half of physicians in all but two countries (Norway and Canada) said they have provisions for after-hours care.

U.S. physicians also were far less likely than their international peers to use HIT—only 46% of U.S. doctors use electronic medical records, compared with 99% of physicians in the Netherlands and 97% of physicians in New Zealand and Norway, the survey showed.

And, insurance restrictions on medications and treatment for patients pose major time concerns for 48% of physicians in the United States, the survey found.

While 42% of physicians in Italy and 34% of physicians in Germany reported similar problems, fewer than 20% of physicians in other countries said insurance restrictions were a major time concern.

The survey did find that in the United States, access to specialists is superior compared with almost all the other countries; only the United Kingdom, where 22% of primary care physicians reported that their patients often experience long waits to see specialists, scored higher.

In comparison, 28% of U.S. physicians reported long waits.

In other countries, notably Italy and Canada, up to three-fourths of primary care physicians reported waiting times for their patients to access specialists.

Many of the areas in which the United States lags behind other countries would be addressed by health reform legislation currently being considered by Congress, commented Commonwealth Fund Senior Vice President Cathy Schoen, lead author of the study.

She noted that other countries have strong national policies to support primary care and HIT.

“These findings are particularly notable when you look at how much countries are spending per person,” said Ms. Schoen.

“The [United States] is by far the most expensive country in this survey, and the gap has been growing without a return in value.”

Meanwhile, other countries are jumping ahead in implementing the patient-centered medical home approach, she said.

“The concept … originated in the United States, but we found that such efforts are spreading faster in other countries,” Ms. Schoen said.

For example, all but two other countries provide a greater percentage of physicians with financial incentives for providing needed chronic or preventive care services or implementing other aspects of the medical home model, the survey showed.

The United States lags behind other countries in terms of adoption of health information technology, providing financial incentives for quality, and improving overall access to care, according to findings from a survey of primary care physicians in 11 countries.

These deficits in primary care, health information technology (HIT), and access have led to lesser quality of care in the United States in several areas compared with other countries, Commonwealth Fund President Karen Davis, Ph.D., said in announcing the results of her organization's International Health Policy Survey.

The survey, results of which were published online in the journal Health Affairs (2009;28:w1171-83), found that 58% of U.S. primary care physicians said their patients often have difficulty paying for medications and care, compared with 5%-37% of patients in the other countries studied.

In addition, 71% of U.S. physicians reported that their practices do not have provisions for after-hours care, forcing patients to seek care in emergency departments, the survey's findings showed. Of the other countries studied, at least half of physicians in all but two countries (Norway and Canada) said they have provisions for after-hours care.

U.S. physicians also were far less likely than were their international peers to use HIT—only 46% of U.S. doctors use electronic medical records, compared with 99% of physicians in the Netherlands and 97% of physicians in New Zealand and Norway, according to survey findings.

On the payment front, insurance restrictions on medications and treatment for patients pose major time concerns for 48% of physicians in the United States, the survey found. While 42% of physicians in Italy and 34% of physicians in Germany reported similar problems, fewer than 20% of physicians in other countries said insurance restrictions posed a major time concern.

Americans' access to specialists is superior compared with almost all the other countries; only the United Kingdom, where 22% of primary care physicians reported that their patients often experience long waits to see specialists, scored higher. In comparison, 28% of U.S. physicians reported long waits.

In other countries, notably Italy and Canada, up to three-fourths of primary care physicians reported waiting times for their patients to access specialists.

Many of the areas in which the United States lags behind other countries would be addressed by health reform legislation currently being considered by Congress, said Commonwealth Fund Senior Vice President Cathy Schoen, lead author of the study. She noted that other countries have strong national policies to support primary care and HIT.

“These findings are particularly notable when you look at how much countries are spending per person,” said Ms. Schoen. “The [United States] is by far the most expensive country in this survey, and the gap has been growing without a return in value.”

Meanwhile, other countries are jumping ahead in implementing the patient-centered medical home approach, she said.

“The concept … originated in the United States, but we found that such efforts are spreading faster in other countries,” Ms. Schoen said.

All but two other countries that participated in the survey provide a greater percentage of physicians with financial incentives for providing needed chronic or preventive care services or implementing other aspects of the medical home model, the survey showed.

For the study, Commonwealth Fund authors surveyed more than 10,000 primary care physicians in Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, the U.K., and the U.S. Data were collected from February through July 2009.

The United States lags behind other countries in terms of adoption of health information technology, providing financial incentives for quality, and improving overall access to care, according to findings from a survey of primary care physicians in 11 countries.

These deficits in primary care, health information technology (HIT), and access have led to lesser quality of care in the United States in several areas compared with other countries, Commonwealth Fund President Karen Davis, Ph.D., said in announcing the results of her organization's International Health Policy Survey.

The survey, results of which were published online in the journal Health Affairs (2009;28:w1171-83), found that 58% of U.S. primary care physicians said their patients often have difficulty paying for medications and care, compared with 5%-37% of patients in the other countries studied.

In addition, 71% of U.S. physicians reported that their practices do not have provisions for after-hours care, forcing patients to seek care in emergency departments, the survey's findings showed. Of the other countries studied, at least half of physicians in all but two countries (Norway and Canada) said they have provisions for after-hours care.

U.S. physicians also were far less likely than were their international peers to use HIT—only 46% of U.S. doctors use electronic medical records, compared with 99% of physicians in the Netherlands and 97% of physicians in New Zealand and Norway, according to survey findings.

On the payment front, insurance restrictions on medications and treatment for patients pose major time concerns for 48% of physicians in the United States, the survey found. While 42% of physicians in Italy and 34% of physicians in Germany reported similar problems, fewer than 20% of physicians in other countries said insurance restrictions posed a major time concern.

Americans' access to specialists is superior compared with almost all the other countries; only the United Kingdom, where 22% of primary care physicians reported that their patients often experience long waits to see specialists, scored higher. In comparison, 28% of U.S. physicians reported long waits.

In other countries, notably Italy and Canada, up to three-fourths of primary care physicians reported waiting times for their patients to access specialists.

Many of the areas in which the United States lags behind other countries would be addressed by health reform legislation currently being considered by Congress, said Commonwealth Fund Senior Vice President Cathy Schoen, lead author of the study. She noted that other countries have strong national policies to support primary care and HIT.

“These findings are particularly notable when you look at how much countries are spending per person,” said Ms. Schoen. “The [United States] is by far the most expensive country in this survey, and the gap has been growing without a return in value.”

Meanwhile, other countries are jumping ahead in implementing the patient-centered medical home approach, she said.

“The concept … originated in the United States, but we found that such efforts are spreading faster in other countries,” Ms. Schoen said.

All but two other countries that participated in the survey provide a greater percentage of physicians with financial incentives for providing needed chronic or preventive care services or implementing other aspects of the medical home model, the survey showed.

For the study, Commonwealth Fund authors surveyed more than 10,000 primary care physicians in Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, the U.K., and the U.S. Data were collected from February through July 2009.

The United States lags behind other countries in terms of adoption of health information technology, providing financial incentives for quality, and improving overall access to care, according to findings from a survey of primary care physicians in 11 countries.

These deficits in primary care, health information technology (HIT), and access have led to lesser quality of care in the United States in several areas compared with other countries, Commonwealth Fund President Karen Davis, Ph.D., said in announcing the results of her organization's International Health Policy Survey.

The survey, results of which were published online in the journal Health Affairs (2009;28:w1171-83), found that 58% of U.S. primary care physicians said their patients often have difficulty paying for medications and care, compared with 5%-37% of patients in the other countries studied.

In addition, 71% of U.S. physicians reported that their practices do not have provisions for after-hours care, forcing patients to seek care in emergency departments, the survey's findings showed. Of the other countries studied, at least half of physicians in all but two countries (Norway and Canada) said they have provisions for after-hours care.

U.S. physicians also were far less likely than were their international peers to use HIT—only 46% of U.S. doctors use electronic medical records, compared with 99% of physicians in the Netherlands and 97% of physicians in New Zealand and Norway, according to survey findings.

On the payment front, insurance restrictions on medications and treatment for patients pose major time concerns for 48% of physicians in the United States, the survey found. While 42% of physicians in Italy and 34% of physicians in Germany reported similar problems, fewer than 20% of physicians in other countries said insurance restrictions posed a major time concern.

Americans' access to specialists is superior compared with almost all the other countries; only the United Kingdom, where 22% of primary care physicians reported that their patients often experience long waits to see specialists, scored higher. In comparison, 28% of U.S. physicians reported long waits.

In other countries, notably Italy and Canada, up to three-fourths of primary care physicians reported waiting times for their patients to access specialists.

Many of the areas in which the United States lags behind other countries would be addressed by health reform legislation currently being considered by Congress, said Commonwealth Fund Senior Vice President Cathy Schoen, lead author of the study. She noted that other countries have strong national policies to support primary care and HIT.

“These findings are particularly notable when you look at how much countries are spending per person,” said Ms. Schoen. “The [United States] is by far the most expensive country in this survey, and the gap has been growing without a return in value.”

Meanwhile, other countries are jumping ahead in implementing the patient-centered medical home approach, she said.

“The concept … originated in the United States, but we found that such efforts are spreading faster in other countries,” Ms. Schoen said.

All but two other countries that participated in the survey provide a greater percentage of physicians with financial incentives for providing needed chronic or preventive care services or implementing other aspects of the medical home model, the survey showed.

For the study, Commonwealth Fund authors surveyed more than 10,000 primary care physicians in Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, the U.K., and the U.S. Data were collected from February through July 2009.

HHS Rewards States for Coverage

The Department of Health and Human Services has awarded more than $72 million in bonuses to nine states for enrolling more eligible children in Medicaid and for making other improvements in that program as well as the Children's Health Insurance Program (CHIP). Funding for the state “performance bonuses” was included in the CHIP reauthorization last year. The states that qualified for bonuses adopted at least five of eight prescribed program features, such as using a joint application for both Medicaid and CHIP and streamlining eligibility renewals. The rewards went to Alaska, Alabama, Illinois, Louisiana, Michigan, New Jersey, New Mexico, Oregon, and Washington.

Marketing Standards Proposed

The Federal Trade Commission and three other federal agencies have unveiled draft standards for companies marketing foods to children aged 2–17 years. Required by a 2009 law, the standards would allow unlimited marketing of pure fruits, fruit juices, vegetables, low-fat milk products, and whole grains but zero marketing of processed foods with high levels of sodium, sugar, trans fats, and saturated fats. Processed foods could be marketed to children only if they were high in healthy ingredients and low in unhealthy ones, the FTC said. The agencies are to give Congress their marketing recommendations this summer. Meanwhile, a study by the advocacy group Children Now found that nearly three-quarters of foods advertised to children on television are in what the Department of Agriculture considers the poorest nutritional category. Advertising for truly healthy products, such as fruits and vegetables, is nearly nonexistent, the group said.

Head Start, Healthy Lifestyles

The majority of Head Start programs report doing more to support healthy eating and physical activity than is required by existing federal regulations, a study showed. Researchers from Temple University, Philadelphia, and Mathematica Policy Research analyzed survey responses from most Head Start programs in the United States. They found that 70% of programs reported serving only nonfat or 1% milk, and 75% of programs reported providing children with at least 30 minutes of adult-led physical activity per day. Federal regulations do not specify the type of milk children should be served, nor do they specify how long children should be physically active each day. Head Start serves 1 million low-income preschool students, 30% of whom are obese or overweight. The study was published in the Archives of Pediatrics and Adolescent Medicine.

Home Visits Fight Asthma

A few home visits by a health care specialist to educate children with asthma about basic strategies for earlier symptom recognition and better medication use can lead to fewer flare-ups and less-frequent trips to the emergency department, a study in Pediatrics showed. Researchers at Johns Hopkins University, Baltimore, found that in-home training on the proper use of inhalers, plus discussions with families about regular access to a pediatrician, were important in preventing attacks. Home visits provided tailored asthma-action plans including lists of must-take daily medications and advice on when to seek emergency care, the researchers said. “We compared several strategies to improve asthma control among children and, much to our delight, we found that taking a few simple steps can go a long way toward doing so,” senior investigator Kristin Riekert, Ph.D., said in a statement.

NIH Focuses on Obesity Prevention

The National Institutes of Health is committing $37 million to research on better ways to reduce obesity. The program, “Translating Basic Behavioral and Social Science Discoveries Into Interventions to Reduce Obesity,” will fund interdisciplinary teams at seven sites. Dr. Francis S. Collins, NIH director, said that the interventions being developed include new ways to promote awareness of eating behaviors, decrease the desire for high-calorie foods, reduce stress-related eating, increase motivation to adhere to weight-loss strategies, engage patients' social networks and communities to encourage physical activity, and improve sleep patterns.

HHS Rewards States for Coverage

The Department of Health and Human Services has awarded more than $72 million in bonuses to nine states for enrolling more eligible children in Medicaid and for making other improvements in that program as well as the Children's Health Insurance Program (CHIP). Funding for the state “performance bonuses” was included in the CHIP reauthorization last year. The states that qualified for bonuses adopted at least five of eight prescribed program features, such as using a joint application for both Medicaid and CHIP and streamlining eligibility renewals. The rewards went to Alaska, Alabama, Illinois, Louisiana, Michigan, New Jersey, New Mexico, Oregon, and Washington.

Marketing Standards Proposed

The Federal Trade Commission and three other federal agencies have unveiled draft standards for companies marketing foods to children aged 2–17 years. Required by a 2009 law, the standards would allow unlimited marketing of pure fruits, fruit juices, vegetables, low-fat milk products, and whole grains but zero marketing of processed foods with high levels of sodium, sugar, trans fats, and saturated fats. Processed foods could be marketed to children only if they were high in healthy ingredients and low in unhealthy ones, the FTC said. The agencies are to give Congress their marketing recommendations this summer. Meanwhile, a study by the advocacy group Children Now found that nearly three-quarters of foods advertised to children on television are in what the Department of Agriculture considers the poorest nutritional category. Advertising for truly healthy products, such as fruits and vegetables, is nearly nonexistent, the group said.

Head Start, Healthy Lifestyles

The majority of Head Start programs report doing more to support healthy eating and physical activity than is required by existing federal regulations, a study showed. Researchers from Temple University, Philadelphia, and Mathematica Policy Research analyzed survey responses from most Head Start programs in the United States. They found that 70% of programs reported serving only nonfat or 1% milk, and 75% of programs reported providing children with at least 30 minutes of adult-led physical activity per day. Federal regulations do not specify the type of milk children should be served, nor do they specify how long children should be physically active each day. Head Start serves 1 million low-income preschool students, 30% of whom are obese or overweight. The study was published in the Archives of Pediatrics and Adolescent Medicine.

Home Visits Fight Asthma

A few home visits by a health care specialist to educate children with asthma about basic strategies for earlier symptom recognition and better medication use can lead to fewer flare-ups and less-frequent trips to the emergency department, a study in Pediatrics showed. Researchers at Johns Hopkins University, Baltimore, found that in-home training on the proper use of inhalers, plus discussions with families about regular access to a pediatrician, were important in preventing attacks. Home visits provided tailored asthma-action plans including lists of must-take daily medications and advice on when to seek emergency care, the researchers said. “We compared several strategies to improve asthma control among children and, much to our delight, we found that taking a few simple steps can go a long way toward doing so,” senior investigator Kristin Riekert, Ph.D., said in a statement.

NIH Focuses on Obesity Prevention

The National Institutes of Health is committing $37 million to research on better ways to reduce obesity. The program, “Translating Basic Behavioral and Social Science Discoveries Into Interventions to Reduce Obesity,” will fund interdisciplinary teams at seven sites. Dr. Francis S. Collins, NIH director, said that the interventions being developed include new ways to promote awareness of eating behaviors, decrease the desire for high-calorie foods, reduce stress-related eating, increase motivation to adhere to weight-loss strategies, engage patients' social networks and communities to encourage physical activity, and improve sleep patterns.

HHS Rewards States for Coverage

The Department of Health and Human Services has awarded more than $72 million in bonuses to nine states for enrolling more eligible children in Medicaid and for making other improvements in that program as well as the Children's Health Insurance Program (CHIP). Funding for the state “performance bonuses” was included in the CHIP reauthorization last year. The states that qualified for bonuses adopted at least five of eight prescribed program features, such as using a joint application for both Medicaid and CHIP and streamlining eligibility renewals. The rewards went to Alaska, Alabama, Illinois, Louisiana, Michigan, New Jersey, New Mexico, Oregon, and Washington.

Marketing Standards Proposed

The Federal Trade Commission and three other federal agencies have unveiled draft standards for companies marketing foods to children aged 2–17 years. Required by a 2009 law, the standards would allow unlimited marketing of pure fruits, fruit juices, vegetables, low-fat milk products, and whole grains but zero marketing of processed foods with high levels of sodium, sugar, trans fats, and saturated fats. Processed foods could be marketed to children only if they were high in healthy ingredients and low in unhealthy ones, the FTC said. The agencies are to give Congress their marketing recommendations this summer. Meanwhile, a study by the advocacy group Children Now found that nearly three-quarters of foods advertised to children on television are in what the Department of Agriculture considers the poorest nutritional category. Advertising for truly healthy products, such as fruits and vegetables, is nearly nonexistent, the group said.

Head Start, Healthy Lifestyles

The majority of Head Start programs report doing more to support healthy eating and physical activity than is required by existing federal regulations, a study showed. Researchers from Temple University, Philadelphia, and Mathematica Policy Research analyzed survey responses from most Head Start programs in the United States. They found that 70% of programs reported serving only nonfat or 1% milk, and 75% of programs reported providing children with at least 30 minutes of adult-led physical activity per day. Federal regulations do not specify the type of milk children should be served, nor do they specify how long children should be physically active each day. Head Start serves 1 million low-income preschool students, 30% of whom are obese or overweight. The study was published in the Archives of Pediatrics and Adolescent Medicine.

Home Visits Fight Asthma

A few home visits by a health care specialist to educate children with asthma about basic strategies for earlier symptom recognition and better medication use can lead to fewer flare-ups and less-frequent trips to the emergency department, a study in Pediatrics showed. Researchers at Johns Hopkins University, Baltimore, found that in-home training on the proper use of inhalers, plus discussions with families about regular access to a pediatrician, were important in preventing attacks. Home visits provided tailored asthma-action plans including lists of must-take daily medications and advice on when to seek emergency care, the researchers said. “We compared several strategies to improve asthma control among children and, much to our delight, we found that taking a few simple steps can go a long way toward doing so,” senior investigator Kristin Riekert, Ph.D., said in a statement.

NIH Focuses on Obesity Prevention

The National Institutes of Health is committing $37 million to research on better ways to reduce obesity. The program, “Translating Basic Behavioral and Social Science Discoveries Into Interventions to Reduce Obesity,” will fund interdisciplinary teams at seven sites. Dr. Francis S. Collins, NIH director, said that the interventions being developed include new ways to promote awareness of eating behaviors, decrease the desire for high-calorie foods, reduce stress-related eating, increase motivation to adhere to weight-loss strategies, engage patients' social networks and communities to encourage physical activity, and improve sleep patterns.

Want more health reform news? Subscribe to our podcast – search 'Policy & Practice' in the iTunes store

State Eyes Gift Restrictions

New Jersey's Division of Consumer Affairs has called on state lawmakers to take a variety of steps, such as banning pharmaceutical company–sponsored meals for physicians, in an effort to curb doctors' conflicts of interest when they prescribe drugs. The division urged 22 reforms, most to be enforced by the N.J. Board of Medical Examiners, that would forbid physicians from accepting free trips, gifts, or meals and would require them to disclose any industry payments over $200 for consulting. However, the proposed regulations would continue to allow pharmaceutical representatives to distribute free drug samples. The consumer affairs division also urged new restrictions on the mining of prescriber-identifiable data and said it wants the lawmakers to ban the sale of such data.

FDA Told to Strengthen Monitoring

The Food and Drug Administration has begun to address weaknesses in its oversight of the safety of drugs once they're approved and marketed, but it still hasn't staffed the effort correctly, the Government Accountability Office said. Previously, the congressional watchdog agency reviewed the regulatory history of the drug Vioxx (rofecoxib), which was pulled from the market in 2004 after being linked to heart attacks and strokes. At that time, the GAO recommended changes in the FDA's program to monitor drugs after they are approved, including clarification of various offices' roles in that effort. However, the GAO said last month that the FDA still does not have a timetable for making those changes. The report called for a comprehensive plan showing which FDA office is responsible for monitoring approved drugs on the market.

Asthma Projects Are Launched

The National Heart, Lung, and Blood Institute has awarded 13 contracts to local organizations to test new evidence-based approaches to managing asthma. The 2-year contracts, worth $1.3 million in total, are part of the National Asthma Control Initiative, which is to strengthen collaborative efforts among patients and families, health care providers, and others involved in managing asthma. The 13 projects include a range of asthma interventions in diverse communities. For example, one will work to reduce asthma triggers in homes and schools, while another will provide Web-based training programs and in-person education for both patients and providers.

Health Centers Get $600M Boost

A total of 85 community health centers in more than 30 states will receive nearly $600 million in American Recovery and Reinvestment Act awards to support expansion through construction and renovation projects and acquisition of health information technology. The awards should help the centers care for more than 500,000 additional patients in underserved communities, said President Obama, who announced the initiative. At the same time, the Centers for Medicare and Medicaid Services will test the impact of the medical home practice model in community health centers, focusing on access, quality, and cost of care for Medicare beneficiaries, President Obama said. Up to 500 centers will eventually participate in the 3-year medical home demonstration, according to the CMS.

Information Tech Gets Funding Too

The recovery act also will fund $235 million in grants to strengthen the existing health information technology (HIT) infrastructure and increase information-exchange capabilities, according to the Department of Health and Human Services. The Beacon Community Program will fund 15 initiatives run by nonprofit organizations or government entities that already have HIT systems in place with wide adoption of electronic medical records. The goal is to show how cutting-edge HIT programs can improve quality, safety, efficiency, and population health while maintaining strong privacy and security measures, the HHS said. The results from the grant program will provide guidance for the use of electronic medical records throughout the United States, the primary goal of the federal government's HIT initiative, the agency said.

Transparency Law Falls Short

Uninsured patients in California are unable to obtain information about the cost of medical care at hospitals, despite recent state legislation designed to improve price transparency, according to a study published in the Journal of General Internal Medicine. For the study, researchers posed as low-income, uninsured patients and asked hospitals for price information. But they received estimates from fewer than one-third of the hospitals approached, and the prices given often were much higher than those allowed under California law, which forbids hospitals from charging the uninsured more for a service than the hospital is paid by a government health plan. In addition, the prices for procedures varied widely. “Few of the estimates we did receive allowed us to make an 'apples to apples' comparison between different hospitals,” said lead author Dr. Kate Farrell of the University of Pittsburgh. The other researchers in the study are with the RAND Corp., the California HealthCare Foundation, and Brown University, Providence, R.I.

Want more health reform news? Subscribe to our podcast – search 'Policy & Practice' in the iTunes store

State Eyes Gift Restrictions

New Jersey's Division of Consumer Affairs has called on state lawmakers to take a variety of steps, such as banning pharmaceutical company–sponsored meals for physicians, in an effort to curb doctors' conflicts of interest when they prescribe drugs. The division urged 22 reforms, most to be enforced by the N.J. Board of Medical Examiners, that would forbid physicians from accepting free trips, gifts, or meals and would require them to disclose any industry payments over $200 for consulting. However, the proposed regulations would continue to allow pharmaceutical representatives to distribute free drug samples. The consumer affairs division also urged new restrictions on the mining of prescriber-identifiable data and said it wants the lawmakers to ban the sale of such data.

FDA Told to Strengthen Monitoring

The Food and Drug Administration has begun to address weaknesses in its oversight of the safety of drugs once they're approved and marketed, but it still hasn't staffed the effort correctly, the Government Accountability Office said. Previously, the congressional watchdog agency reviewed the regulatory history of the drug Vioxx (rofecoxib), which was pulled from the market in 2004 after being linked to heart attacks and strokes. At that time, the GAO recommended changes in the FDA's program to monitor drugs after they are approved, including clarification of various offices' roles in that effort. However, the GAO said last month that the FDA still does not have a timetable for making those changes. The report called for a comprehensive plan showing which FDA office is responsible for monitoring approved drugs on the market.

Asthma Projects Are Launched

The National Heart, Lung, and Blood Institute has awarded 13 contracts to local organizations to test new evidence-based approaches to managing asthma. The 2-year contracts, worth $1.3 million in total, are part of the National Asthma Control Initiative, which is to strengthen collaborative efforts among patients and families, health care providers, and others involved in managing asthma. The 13 projects include a range of asthma interventions in diverse communities. For example, one will work to reduce asthma triggers in homes and schools, while another will provide Web-based training programs and in-person education for both patients and providers.

Health Centers Get $600M Boost

A total of 85 community health centers in more than 30 states will receive nearly $600 million in American Recovery and Reinvestment Act awards to support expansion through construction and renovation projects and acquisition of health information technology. The awards should help the centers care for more than 500,000 additional patients in underserved communities, said President Obama, who announced the initiative. At the same time, the Centers for Medicare and Medicaid Services will test the impact of the medical home practice model in community health centers, focusing on access, quality, and cost of care for Medicare beneficiaries, President Obama said. Up to 500 centers will eventually participate in the 3-year medical home demonstration, according to the CMS.

Information Tech Gets Funding Too

The recovery act also will fund $235 million in grants to strengthen the existing health information technology (HIT) infrastructure and increase information-exchange capabilities, according to the Department of Health and Human Services. The Beacon Community Program will fund 15 initiatives run by nonprofit organizations or government entities that already have HIT systems in place with wide adoption of electronic medical records. The goal is to show how cutting-edge HIT programs can improve quality, safety, efficiency, and population health while maintaining strong privacy and security measures, the HHS said. The results from the grant program will provide guidance for the use of electronic medical records throughout the United States, the primary goal of the federal government's HIT initiative, the agency said.

Transparency Law Falls Short

Uninsured patients in California are unable to obtain information about the cost of medical care at hospitals, despite recent state legislation designed to improve price transparency, according to a study published in the Journal of General Internal Medicine. For the study, researchers posed as low-income, uninsured patients and asked hospitals for price information. But they received estimates from fewer than one-third of the hospitals approached, and the prices given often were much higher than those allowed under California law, which forbids hospitals from charging the uninsured more for a service than the hospital is paid by a government health plan. In addition, the prices for procedures varied widely. “Few of the estimates we did receive allowed us to make an 'apples to apples' comparison between different hospitals,” said lead author Dr. Kate Farrell of the University of Pittsburgh. The other researchers in the study are with the RAND Corp., the California HealthCare Foundation, and Brown University, Providence, R.I.

Want more health reform news? Subscribe to our podcast – search 'Policy & Practice' in the iTunes store

State Eyes Gift Restrictions

New Jersey's Division of Consumer Affairs has called on state lawmakers to take a variety of steps, such as banning pharmaceutical company–sponsored meals for physicians, in an effort to curb doctors' conflicts of interest when they prescribe drugs. The division urged 22 reforms, most to be enforced by the N.J. Board of Medical Examiners, that would forbid physicians from accepting free trips, gifts, or meals and would require them to disclose any industry payments over $200 for consulting. However, the proposed regulations would continue to allow pharmaceutical representatives to distribute free drug samples. The consumer affairs division also urged new restrictions on the mining of prescriber-identifiable data and said it wants the lawmakers to ban the sale of such data.

FDA Told to Strengthen Monitoring

The Food and Drug Administration has begun to address weaknesses in its oversight of the safety of drugs once they're approved and marketed, but it still hasn't staffed the effort correctly, the Government Accountability Office said. Previously, the congressional watchdog agency reviewed the regulatory history of the drug Vioxx (rofecoxib), which was pulled from the market in 2004 after being linked to heart attacks and strokes. At that time, the GAO recommended changes in the FDA's program to monitor drugs after they are approved, including clarification of various offices' roles in that effort. However, the GAO said last month that the FDA still does not have a timetable for making those changes. The report called for a comprehensive plan showing which FDA office is responsible for monitoring approved drugs on the market.

Asthma Projects Are Launched

The National Heart, Lung, and Blood Institute has awarded 13 contracts to local organizations to test new evidence-based approaches to managing asthma. The 2-year contracts, worth $1.3 million in total, are part of the National Asthma Control Initiative, which is to strengthen collaborative efforts among patients and families, health care providers, and others involved in managing asthma. The 13 projects include a range of asthma interventions in diverse communities. For example, one will work to reduce asthma triggers in homes and schools, while another will provide Web-based training programs and in-person education for both patients and providers.

Health Centers Get $600M Boost

A total of 85 community health centers in more than 30 states will receive nearly $600 million in American Recovery and Reinvestment Act awards to support expansion through construction and renovation projects and acquisition of health information technology. The awards should help the centers care for more than 500,000 additional patients in underserved communities, said President Obama, who announced the initiative. At the same time, the Centers for Medicare and Medicaid Services will test the impact of the medical home practice model in community health centers, focusing on access, quality, and cost of care for Medicare beneficiaries, President Obama said. Up to 500 centers will eventually participate in the 3-year medical home demonstration, according to the CMS.

Information Tech Gets Funding Too

The recovery act also will fund $235 million in grants to strengthen the existing health information technology (HIT) infrastructure and increase information-exchange capabilities, according to the Department of Health and Human Services. The Beacon Community Program will fund 15 initiatives run by nonprofit organizations or government entities that already have HIT systems in place with wide adoption of electronic medical records. The goal is to show how cutting-edge HIT programs can improve quality, safety, efficiency, and population health while maintaining strong privacy and security measures, the HHS said. The results from the grant program will provide guidance for the use of electronic medical records throughout the United States, the primary goal of the federal government's HIT initiative, the agency said.

Transparency Law Falls Short

Uninsured patients in California are unable to obtain information about the cost of medical care at hospitals, despite recent state legislation designed to improve price transparency, according to a study published in the Journal of General Internal Medicine. For the study, researchers posed as low-income, uninsured patients and asked hospitals for price information. But they received estimates from fewer than one-third of the hospitals approached, and the prices given often were much higher than those allowed under California law, which forbids hospitals from charging the uninsured more for a service than the hospital is paid by a government health plan. In addition, the prices for procedures varied widely. “Few of the estimates we did receive allowed us to make an 'apples to apples' comparison between different hospitals,” said lead author Dr. Kate Farrell of the University of Pittsburgh. The other researchers in the study are with the RAND Corp., the California HealthCare Foundation, and Brown University, Providence, R.I.

State Eyes Gift Restrictions

New Jersey's Division of Consumer Affairs has called on state lawmakers to take a variety of steps, such as banning pharmaceutical company–sponsored meals for physicians, in an effort to curb doctors' conflicts of interest when they prescribe drugs. The division urged 22 reforms, most to be enforced by the N.J. Board of Medical Examiners, that would forbid physicians from accepting free trips, gifts, or meals and would require them to disclose any industry payments over $200 for consulting. However, the proposed regulations would continue to allow pharmaceutical representatives to distribute free drug samples. The consumer affairs division also urged new restrictions on the mining of prescriber-identifiable data and said it wants the lawmakers to ban the sale of such data.

FDA Told to Strengthen Monitoring

The Food and Drug Administration has begun to address weaknesses in its oversight of the safety of drugs once they're approved and marketed, but it still hasn't staffed the effort correctly, the Government Accountability Office said. Previously, the congressional watchdog agency reviewed the regulatory history of the drug Vioxx (rofecoxib), which was pulled from the market in 2004 after being linked to heart attacks and strokes. At that time, the GAO recommended changes in the FDA's program to monitor drugs after they are approved, including clarification of various offices' roles in that effort. However, the GAO said last month that the FDA still does not have a timetable for making those changes. The report called for a comprehensive plan showing which FDA office is responsible for monitoring approved drugs on the market.

Asthma Projects Are Launched

The National Heart, Lung, and Blood Institute has awarded 13 contracts to local organizations to test new evidence-based approaches to managing asthma. The 2-year contracts, worth $1.3 million in total, are part of the National Asthma Control Initiative, which is to strengthen collaborative efforts among patients and families, health care providers, and others involved in managing asthma. The 13 projects include a range of asthma interventions in diverse communities. For example, one will work to reduce asthma triggers in homes and schools, while another will provide Web-based training programs and in-person education for both patients and providers.

Health Centers Get $600M Boost

A total of 85 community health centers in more than 30 states will receive nearly $600 million in American Recovery and Reinvestment Act awards to support expansion through construction and renovation projects and acquisition of health information technology. The awards should help the centers care for more than 500,000 additional patients in underserved communities, said President Obama, who announced the initiative. At the same time, the Centers for Medicare and Medicaid Services will test the impact of the medical home practice model in community health centers, focusing on access, quality, and cost of care for Medicare beneficiaries, President Obama said. Up to 500 centers will eventually participate in the 3-year medical home demonstration, according to the CMS.

Information Tech Gets Funding Too

The recovery act also will fund $235 million in grants to strengthen the existing health information technology (HIT) infrastructure and increase information-exchange capabilities, according to the Department of Health and Human Services. The Beacon Community Program will fund 15 initiatives run by nonprofit organizations or government entities that already have HIT systems in place with wide adoption of electronic medical records. The goal of the program is to show how cutting-edge HIT programs can improve quality, safety, efficiency, and population health while maintaining strong privacy and security measures, the HHS said. The results from the grant program will provide guidance for the use of electronic medical records throughout the United States, the primary goal of the federal government's HIT initiative.

Transparency Law Falls Short

Uninsured patients in California are unable to obtain information about the cost of medical care at hospitals, despite recent state legislation designed to improve price transparency, according to a study published in the Journal of General Internal Medicine. For the study, researchers posed as low-income, uninsured patients and asked hospitals for price information. They received estimates from fewer than one-third of the hospitals approached, and the prices given often were much higher than those allowed under California law, which forbids hospitals from charging the uninsured more. In addition, the prices for procedures varied widely—for example, the quotes for a colonoscopy ranged from $216 to $1,748. “Few of the estimates we did receive allowed us to make an 'apples to apples' comparison between different hospitals,” said lead author Dr. Kate Farrell of the University of Pittsburgh. The other researchers in the study are with the RAND Corp., the California HealthCare Foundation, and Brown University, Providence, R.I.

State Eyes Gift Restrictions

New Jersey's Division of Consumer Affairs has called on state lawmakers to take a variety of steps, such as banning pharmaceutical company–sponsored meals for physicians, in an effort to curb doctors' conflicts of interest when they prescribe drugs. The division urged 22 reforms, most to be enforced by the N.J. Board of Medical Examiners, that would forbid physicians from accepting free trips, gifts, or meals and would require them to disclose any industry payments over $200 for consulting. However, the proposed regulations would continue to allow pharmaceutical representatives to distribute free drug samples. The consumer affairs division also urged new restrictions on the mining of prescriber-identifiable data and said it wants the lawmakers to ban the sale of such data.

FDA Told to Strengthen Monitoring

The Food and Drug Administration has begun to address weaknesses in its oversight of the safety of drugs once they're approved and marketed, but it still hasn't staffed the effort correctly, the Government Accountability Office said. Previously, the congressional watchdog agency reviewed the regulatory history of the drug Vioxx (rofecoxib), which was pulled from the market in 2004 after being linked to heart attacks and strokes. At that time, the GAO recommended changes in the FDA's program to monitor drugs after they are approved, including clarification of various offices' roles in that effort. However, the GAO said last month that the FDA still does not have a timetable for making those changes. The report called for a comprehensive plan showing which FDA office is responsible for monitoring approved drugs on the market.

Asthma Projects Are Launched

The National Heart, Lung, and Blood Institute has awarded 13 contracts to local organizations to test new evidence-based approaches to managing asthma. The 2-year contracts, worth $1.3 million in total, are part of the National Asthma Control Initiative, which is to strengthen collaborative efforts among patients and families, health care providers, and others involved in managing asthma. The 13 projects include a range of asthma interventions in diverse communities. For example, one will work to reduce asthma triggers in homes and schools, while another will provide Web-based training programs and in-person education for both patients and providers.

Health Centers Get $600M Boost

A total of 85 community health centers in more than 30 states will receive nearly $600 million in American Recovery and Reinvestment Act awards to support expansion through construction and renovation projects and acquisition of health information technology. The awards should help the centers care for more than 500,000 additional patients in underserved communities, said President Obama, who announced the initiative. At the same time, the Centers for Medicare and Medicaid Services will test the impact of the medical home practice model in community health centers, focusing on access, quality, and cost of care for Medicare beneficiaries, President Obama said. Up to 500 centers will eventually participate in the 3-year medical home demonstration, according to the CMS.

Information Tech Gets Funding Too

The recovery act also will fund $235 million in grants to strengthen the existing health information technology (HIT) infrastructure and increase information-exchange capabilities, according to the Department of Health and Human Services. The Beacon Community Program will fund 15 initiatives run by nonprofit organizations or government entities that already have HIT systems in place with wide adoption of electronic medical records. The goal of the program is to show how cutting-edge HIT programs can improve quality, safety, efficiency, and population health while maintaining strong privacy and security measures, the HHS said. The results from the grant program will provide guidance for the use of electronic medical records throughout the United States, the primary goal of the federal government's HIT initiative.

Transparency Law Falls Short

Uninsured patients in California are unable to obtain information about the cost of medical care at hospitals, despite recent state legislation designed to improve price transparency, according to a study published in the Journal of General Internal Medicine. For the study, researchers posed as low-income, uninsured patients and asked hospitals for price information. They received estimates from fewer than one-third of the hospitals approached, and the prices given often were much higher than those allowed under California law, which forbids hospitals from charging the uninsured more. In addition, the prices for procedures varied widely—for example, the quotes for a colonoscopy ranged from $216 to $1,748. “Few of the estimates we did receive allowed us to make an 'apples to apples' comparison between different hospitals,” said lead author Dr. Kate Farrell of the University of Pittsburgh. The other researchers in the study are with the RAND Corp., the California HealthCare Foundation, and Brown University, Providence, R.I.

State Eyes Gift Restrictions

New Jersey's Division of Consumer Affairs has called on state lawmakers to take a variety of steps, such as banning pharmaceutical company–sponsored meals for physicians, in an effort to curb doctors' conflicts of interest when they prescribe drugs. The division urged 22 reforms, most to be enforced by the N.J. Board of Medical Examiners, that would forbid physicians from accepting free trips, gifts, or meals and would require them to disclose any industry payments over $200 for consulting. However, the proposed regulations would continue to allow pharmaceutical representatives to distribute free drug samples. The consumer affairs division also urged new restrictions on the mining of prescriber-identifiable data and said it wants the lawmakers to ban the sale of such data.

FDA Told to Strengthen Monitoring

The Food and Drug Administration has begun to address weaknesses in its oversight of the safety of drugs once they're approved and marketed, but it still hasn't staffed the effort correctly, the Government Accountability Office said. Previously, the congressional watchdog agency reviewed the regulatory history of the drug Vioxx (rofecoxib), which was pulled from the market in 2004 after being linked to heart attacks and strokes. At that time, the GAO recommended changes in the FDA's program to monitor drugs after they are approved, including clarification of various offices' roles in that effort. However, the GAO said last month that the FDA still does not have a timetable for making those changes. The report called for a comprehensive plan showing which FDA office is responsible for monitoring approved drugs on the market.

Asthma Projects Are Launched

The National Heart, Lung, and Blood Institute has awarded 13 contracts to local organizations to test new evidence-based approaches to managing asthma. The 2-year contracts, worth $1.3 million in total, are part of the National Asthma Control Initiative, which is to strengthen collaborative efforts among patients and families, health care providers, and others involved in managing asthma. The 13 projects include a range of asthma interventions in diverse communities. For example, one will work to reduce asthma triggers in homes and schools, while another will provide Web-based training programs and in-person education for both patients and providers.

Health Centers Get $600M Boost

A total of 85 community health centers in more than 30 states will receive nearly $600 million in American Recovery and Reinvestment Act awards to support expansion through construction and renovation projects and acquisition of health information technology. The awards should help the centers care for more than 500,000 additional patients in underserved communities, said President Obama, who announced the initiative. At the same time, the Centers for Medicare and Medicaid Services will test the impact of the medical home practice model in community health centers, focusing on access, quality, and cost of care for Medicare beneficiaries, President Obama said. Up to 500 centers will eventually participate in the 3-year medical home demonstration, according to the CMS.

Information Tech Gets Funding Too

The recovery act also will fund $235 million in grants to strengthen the existing health information technology (HIT) infrastructure and increase information-exchange capabilities, according to the Department of Health and Human Services. The Beacon Community Program will fund 15 initiatives run by nonprofit organizations or government entities that already have HIT systems in place with wide adoption of electronic medical records. The goal of the program is to show how cutting-edge HIT programs can improve quality, safety, efficiency, and population health while maintaining strong privacy and security measures, the HHS said. The results from the grant program will provide guidance for the use of electronic medical records throughout the United States, the primary goal of the federal government's HIT initiative.

Transparency Law Falls Short

Uninsured patients in California are unable to obtain information about the cost of medical care at hospitals, despite recent state legislation designed to improve price transparency, according to a study published in the Journal of General Internal Medicine. For the study, researchers posed as low-income, uninsured patients and asked hospitals for price information. They received estimates from fewer than one-third of the hospitals approached, and the prices given often were much higher than those allowed under California law, which forbids hospitals from charging the uninsured more. In addition, the prices for procedures varied widely—for example, the quotes for a colonoscopy ranged from $216 to $1,748. “Few of the estimates we did receive allowed us to make an 'apples to apples' comparison between different hospitals,” said lead author Dr. Kate Farrell of the University of Pittsburgh. The other researchers in the study are with the RAND Corp., the California HealthCare Foundation, and Brown University, Providence, R.I.

Hospital Deaths Higher in Uninsured

Having no health insurance might have contributed to nearly 17,000 deaths among hospitalized U.S. children from 1988 to 2005, according to research led by the Johns Hopkins Children's Center. Using more than 23 million hospital records, the investigators compared the risk of death in children who had insurance with that of children without coverage. The uninsured were 60% more likely to die in the hospital. The increased risk persisted regardless of medical condition. The researchers said that their study didn't establish cause and effect despite the powerful link between coverage and mortality risk.

Many Eligible Children Not Insured

Although the number of children without health insurance declined by 800,000 from 2007 to 2008, around 5 million children are eligible today for Medicaid or the Children's Health Insurance Program but not enrolled, according to the Urban Institute. Those eligible children represent nearly two-thirds of all uninsured children, the policy group said. Streamlining state application and retention processes for the public-insurance programs could increase enrollment among these children, the group said. For example, more than 90% of low-income parents said they would enroll their uninsured child if he or she were eligible. However, half of these parents didn't know their child was eligible, did not know how to apply, or found the application process difficult. The study also recommended that states target outreach efforts to teenagers and Hispanics, both of which are groups with low enrollment rates.

Parents Oppose High-Calorie Snacks

The vast majority of parents want schools to limit students' access to high-calorie chips, sodas, and candy and to offer them opportunities for physical activity throughout the day, a survey by the Alliance for a Healthier Generation shows. In fact, more than 92% of parents consider physical education and health education as important as English, math, and science lessons. Two-thirds of parents said schools play a major role in instilling healthy habits in children. Eight in 10 parents said they wish to help create a healthier environment in schools. Many said they have done so already by volunteering and bringing in healthy food.

Daily TV Viewing Averages 3 Hours

American children aged 2–11 are watching an average of more than 3 hours of television each day, which represents an 8-year high, the Nielsen Co. reported. Children aged 2–5 spend more than 32 hours a week on average in front of a TV or computer screen. Children aged 6–11 spend a little less time in front of a screen—about 28 hours per week in total—but they spend more time playing video games, the TV-rating service said. Internet use is also higher among these older children: Nearly half of 6- to 11-year-olds spent time online in August, compared with 20% of younger children.

Teen Parents Defy Stereotypes

While many Americans assume that teenaged parents come from impoverished, single-parent homes, teen pregnancy happens across the socioeconomic spectrum, according to a new analysis. Surveys of middle- and high-school students show that 39% of teens who had ever given birth to or fathered a child as a teenager were living with two biologic or adoptive parents before the birth, the National Campaign to Prevent Teen and Unplanned Pregnancy reported. About 72% of teens who had either fathered a child or given birth as a teenager were living in households that were above the federal poverty level. “Despite what many may believe, teen childbearing is not limited to a particular income group or family structure, which means that prevention efforts must be broad in their design and reach,” Sarah Brown, CEO of the National Campaign to Prevent Teen and Unintended Pregnancy, said in a statement.

Hospital Deaths Higher in Uninsured

Having no health insurance might have contributed to nearly 17,000 deaths among hospitalized U.S. children from 1988 to 2005, according to research led by the Johns Hopkins Children's Center. Using more than 23 million hospital records, the investigators compared the risk of death in children who had insurance with that of children without coverage. The uninsured were 60% more likely to die in the hospital. The increased risk persisted regardless of medical condition. The researchers said that their study didn't establish cause and effect despite the powerful link between coverage and mortality risk.

Many Eligible Children Not Insured

Although the number of children without health insurance declined by 800,000 from 2007 to 2008, around 5 million children are eligible today for Medicaid or the Children's Health Insurance Program but not enrolled, according to the Urban Institute. Those eligible children represent nearly two-thirds of all uninsured children, the policy group said. Streamlining state application and retention processes for the public-insurance programs could increase enrollment among these children, the group said. For example, more than 90% of low-income parents said they would enroll their uninsured child if he or she were eligible. However, half of these parents didn't know their child was eligible, did not know how to apply, or found the application process difficult. The study also recommended that states target outreach efforts to teenagers and Hispanics, both of which are groups with low enrollment rates.

Parents Oppose High-Calorie Snacks

The vast majority of parents want schools to limit students' access to high-calorie chips, sodas, and candy and to offer them opportunities for physical activity throughout the day, a survey by the Alliance for a Healthier Generation shows. In fact, more than 92% of parents consider physical education and health education as important as English, math, and science lessons. Two-thirds of parents said schools play a major role in instilling healthy habits in children. Eight in 10 parents said they wish to help create a healthier environment in schools. Many said they have done so already by volunteering and bringing in healthy food.

Daily TV Viewing Averages 3 Hours

American children aged 2–11 are watching an average of more than 3 hours of television each day, which represents an 8-year high, the Nielsen Co. reported. Children aged 2–5 spend more than 32 hours a week on average in front of a TV or computer screen. Children aged 6–11 spend a little less time in front of a screen—about 28 hours per week in total—but they spend more time playing video games, the TV-rating service said. Internet use is also higher among these older children: Nearly half of 6- to 11-year-olds spent time online in August, compared with 20% of younger children.

Teen Parents Defy Stereotypes

While many Americans assume that teenaged parents come from impoverished, single-parent homes, teen pregnancy happens across the socioeconomic spectrum, according to a new analysis. Surveys of middle- and high-school students show that 39% of teens who had ever given birth to or fathered a child as a teenager were living with two biologic or adoptive parents before the birth, the National Campaign to Prevent Teen and Unplanned Pregnancy reported. About 72% of teens who had either fathered a child or given birth as a teenager were living in households that were above the federal poverty level. “Despite what many may believe, teen childbearing is not limited to a particular income group or family structure, which means that prevention efforts must be broad in their design and reach,” Sarah Brown, CEO of the National Campaign to Prevent Teen and Unintended Pregnancy, said in a statement.

Hospital Deaths Higher in Uninsured

Having no health insurance might have contributed to nearly 17,000 deaths among hospitalized U.S. children from 1988 to 2005, according to research led by the Johns Hopkins Children's Center. Using more than 23 million hospital records, the investigators compared the risk of death in children who had insurance with that of children without coverage. The uninsured were 60% more likely to die in the hospital. The increased risk persisted regardless of medical condition. The researchers said that their study didn't establish cause and effect despite the powerful link between coverage and mortality risk.

Many Eligible Children Not Insured

Although the number of children without health insurance declined by 800,000 from 2007 to 2008, around 5 million children are eligible today for Medicaid or the Children's Health Insurance Program but not enrolled, according to the Urban Institute. Those eligible children represent nearly two-thirds of all uninsured children, the policy group said. Streamlining state application and retention processes for the public-insurance programs could increase enrollment among these children, the group said. For example, more than 90% of low-income parents said they would enroll their uninsured child if he or she were eligible. However, half of these parents didn't know their child was eligible, did not know how to apply, or found the application process difficult. The study also recommended that states target outreach efforts to teenagers and Hispanics, both of which are groups with low enrollment rates.

Parents Oppose High-Calorie Snacks

The vast majority of parents want schools to limit students' access to high-calorie chips, sodas, and candy and to offer them opportunities for physical activity throughout the day, a survey by the Alliance for a Healthier Generation shows. In fact, more than 92% of parents consider physical education and health education as important as English, math, and science lessons. Two-thirds of parents said schools play a major role in instilling healthy habits in children. Eight in 10 parents said they wish to help create a healthier environment in schools. Many said they have done so already by volunteering and bringing in healthy food.

Daily TV Viewing Averages 3 Hours

American children aged 2–11 are watching an average of more than 3 hours of television each day, which represents an 8-year high, the Nielsen Co. reported. Children aged 2–5 spend more than 32 hours a week on average in front of a TV or computer screen. Children aged 6–11 spend a little less time in front of a screen—about 28 hours per week in total—but they spend more time playing video games, the TV-rating service said. Internet use is also higher among these older children: Nearly half of 6- to 11-year-olds spent time online in August, compared with 20% of younger children.

Teen Parents Defy Stereotypes

While many Americans assume that teenaged parents come from impoverished, single-parent homes, teen pregnancy happens across the socioeconomic spectrum, according to a new analysis. Surveys of middle- and high-school students show that 39% of teens who had ever given birth to or fathered a child as a teenager were living with two biologic or adoptive parents before the birth, the National Campaign to Prevent Teen and Unplanned Pregnancy reported. About 72% of teens who had either fathered a child or given birth as a teenager were living in households that were above the federal poverty level. “Despite what many may believe, teen childbearing is not limited to a particular income group or family structure, which means that prevention efforts must be broad in their design and reach,” Sarah Brown, CEO of the National Campaign to Prevent Teen and Unintended Pregnancy, said in a statement.

The United States lags behind other countries in terms of adoption of health information technology, providing financial incentives for quality, and improving overall access to care, according to findings from a survey of primary care physicians in 11 countries.

These deficits in primary care, health information technology (HIT), and access have led to lesser quality of care in the United States in several areas compared with other countries, Commonwealth Fund President Karen Davis, Ph.D., said during a teleconference in announcing the results of her organization's International Health Policy Survey.

The survey, results of which were published online in the journal Health Affairs (2009;28:w1171-83), found that 58% of U.S. primary care physicians said their patients often have difficulty paying for medications and care, compared with 5%–37% of patients in the other countries studied.

In addition, 71% of U.S. physicians reported that their practices do not have provisions for after-hours care, forcing patients to seek care in emergency departments, the survey showed. Of the other countries studied, at least half of physicians in all but two countries (Norway and Canada) said they have provisions for after-hours care.

U.S. physicians also were far less likely than their international peers to use HIT—only 46% of U.S. doctors use electronic medical records, compared with 99% of physicians in the Netherlands and 97% of physicians in New Zealand and Norway, the survey showed.

Meanwhile, other countries are jumping ahead in implementing the patient-centered medical home approach, she said. “The concept … originated in the United States, but we found that such efforts are spreading faster in other countries,” Ms. Schoen said.

For example, all but two other countries provide a greater percentage of physicians with financial incentives for providing needed chronic or preventive care services or implementing other aspects of the medical home model, the survey showed.

For the study, Commonwealth Fund authors surveyed more than 10,000 primary care physicians in Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, the United Kingdom, and the United States.

Data were collected from February through July 2009.

The United States lags behind other countries in terms of adoption of health information technology, providing financial incentives for quality, and improving overall access to care, according to findings from a survey of primary care physicians in 11 countries.

These deficits in primary care, health information technology (HIT), and access have led to lesser quality of care in the United States in several areas compared with other countries, Commonwealth Fund President Karen Davis, Ph.D., said during a teleconference in announcing the results of her organization's International Health Policy Survey.

The survey, results of which were published online in the journal Health Affairs (2009;28:w1171-83), found that 58% of U.S. primary care physicians said their patients often have difficulty paying for medications and care, compared with 5%–37% of patients in the other countries studied.

In addition, 71% of U.S. physicians reported that their practices do not have provisions for after-hours care, forcing patients to seek care in emergency departments, the survey showed. Of the other countries studied, at least half of physicians in all but two countries (Norway and Canada) said they have provisions for after-hours care.

U.S. physicians also were far less likely than their international peers to use HIT—only 46% of U.S. doctors use electronic medical records, compared with 99% of physicians in the Netherlands and 97% of physicians in New Zealand and Norway, the survey showed.

Meanwhile, other countries are jumping ahead in implementing the patient-centered medical home approach, she said. “The concept … originated in the United States, but we found that such efforts are spreading faster in other countries,” Ms. Schoen said.

For example, all but two other countries provide a greater percentage of physicians with financial incentives for providing needed chronic or preventive care services or implementing other aspects of the medical home model, the survey showed.

For the study, Commonwealth Fund authors surveyed more than 10,000 primary care physicians in Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, the United Kingdom, and the United States.

Data were collected from February through July 2009.

The United States lags behind other countries in terms of adoption of health information technology, providing financial incentives for quality, and improving overall access to care, according to findings from a survey of primary care physicians in 11 countries.

These deficits in primary care, health information technology (HIT), and access have led to lesser quality of care in the United States in several areas compared with other countries, Commonwealth Fund President Karen Davis, Ph.D., said during a teleconference in announcing the results of her organization's International Health Policy Survey.

The survey, results of which were published online in the journal Health Affairs (2009;28:w1171-83), found that 58% of U.S. primary care physicians said their patients often have difficulty paying for medications and care, compared with 5%–37% of patients in the other countries studied.

In addition, 71% of U.S. physicians reported that their practices do not have provisions for after-hours care, forcing patients to seek care in emergency departments, the survey showed. Of the other countries studied, at least half of physicians in all but two countries (Norway and Canada) said they have provisions for after-hours care.

U.S. physicians also were far less likely than their international peers to use HIT—only 46% of U.S. doctors use electronic medical records, compared with 99% of physicians in the Netherlands and 97% of physicians in New Zealand and Norway, the survey showed.

Meanwhile, other countries are jumping ahead in implementing the patient-centered medical home approach, she said. “The concept … originated in the United States, but we found that such efforts are spreading faster in other countries,” Ms. Schoen said.

For example, all but two other countries provide a greater percentage of physicians with financial incentives for providing needed chronic or preventive care services or implementing other aspects of the medical home model, the survey showed.

For the study, Commonwealth Fund authors surveyed more than 10,000 primary care physicians in Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, the United Kingdom, and the United States.

Data were collected from February through July 2009.

Adverse Event Reports Go Unused

The Food and Drug Administration's Center for Devices and Radiological Health fails to use adverse event reports in a systematic manner to detect and address medical device safety problems, a report from the HHS Office of the Inspector General found. Manufacturers and medical facilities are required to promptly submit reports to the FDA center following adverse events, which can include deaths, serious injuries, and device malfunctions. But the center has no documentation of following up on these events, and it fails to read most reports in a timely fashion, according to the report. Meanwhile, reports of problems with medical devices are increasing, the Inspector General's office found: The FDA center received about 73,000 adverse event reports in 2003 but more than 150,000 in 2007. The Inspector General recommended that the center develop better protocols for reviewing and tracking the reports.

Medicare's Improper Payments

The Centers for Medicare and Medicaid Services made approximately $24 billion in improper payments in fiscal year 2009, an error rate that was almost double the rate of the previous year. In fiscal year 2009, 7.8% of Medicare fee-for-service claims were paid in error, compared with 3.5% in fiscal year 2008, said the agency in a statement. The CMS said that the increase in the error rate resulted largely from a change in how it identified improper payments. “This year, we made the call to stop calculating our error rate in fee-for-service Medicare the way that the previous administration did and to start using a more rigorous method in calculating this rate in keeping with our mandate to root out errors and fraud,” Health and Human Services Secretary Kathleen Sebelius said in a statement. The CMS said that the higher improper payment rate is not necessarily an indicator of greater fraud. Rather, it was “a more complete accounting of errors,” according to Ms. Sebelius.

Employers Favor Family Plans

Employer contributions to health savings accounts, which are integral to “consumer-driven” health plans, are shifting to favor family-coverage plans, according to the Employee Benefit Research Institute. Workers with employee-only coverage have seen annual employer contributions to their health savings accounts decline, but those with family coverage saw increases in 2009, the institute said. About 4% of Americans have consumer-driven health plans, the report said, and about 63% of employers offering such plans make contributions to their workers' health savings accounts.

Electronic Tools Effective: AHRQ

Consumer health informatics—electronic tools and applications designed to provide tailored health advice to patients—could save money by eliminating the need for some health education activities now performed by clinicians, said a report from the Agency for Healthcare Research and Quality. Health informatics also could improve clinician-patient interactions dealing with a wide variety of diseases and health issues, the AHRQ said. The agency reviewed more than 100 studies of consumers getting health information via the Web, computer programs, and other electronic avenues such as texting and chat groups. The analysis found that the most effective health informatics applications tailor messages using a patients' own health information and provide feedback about the that person's progress as the intervention progresses.

Provider Fraud Most Common

By far, most health care fraud—80%—involves providers systematically overcharging public or private insurers, according to a report from researchers at George Washington University, Washington, and the National Academy for State Health Policy. The study found that these schemes disproportionately target demographic groups likely to be enrolled in Medicare and Medicaid. However, the researchers also found that fraud information concerning the public programs is frequently confused with payment-error data. The authors recommended stronger laws governing insurance marketing, enrollment, claims payments, and antifraud procedures.

DEA Effort Delays Pain Relief

Efforts by the Drug Enforcement Administration to prevent the theft of prescription narcotics are denying pain relief to many nursing home, hospice, and other long-term care patients, two senators said in a letter to Attorney General Eric Holder. Sen. Herb Kohl (D-Wis.), chairman of the Senate Special Committee on Aging, and Sen. Sheldon Whitehouse (D-R.I.) called on Holder to issue new directives to the DEA. The senators proposed legislation that they said could fix the problem. To deter diversion of prescription drugs, the agency stepped up enforcement of laws that require pharmacies to obtain hard copies of prescriptions with signatures from physicians, instead of routine medication orders, for controlled substances prescribed in residential-care settings. This has disrupted “well-established medication coordination protocols” and led to delays in providing those medications to sick patients, the two lawmakers said.

Adverse Event Reports Go Unused

The Food and Drug Administration's Center for Devices and Radiological Health fails to use adverse event reports in a systematic manner to detect and address medical device safety problems, a report from the HHS Office of the Inspector General found. Manufacturers and medical facilities are required to promptly submit reports to the FDA center following adverse events, which can include deaths, serious injuries, and device malfunctions. But the center has no documentation of following up on these events, and it fails to read most reports in a timely fashion, according to the report. Meanwhile, reports of problems with medical devices are increasing, the Inspector General's office found: The FDA center received about 73,000 adverse event reports in 2003 but more than 150,000 in 2007. The Inspector General recommended that the center develop better protocols for reviewing and tracking the reports.

Medicare's Improper Payments

The Centers for Medicare and Medicaid Services made approximately $24 billion in improper payments in fiscal year 2009, an error rate that was almost double the rate of the previous year. In fiscal year 2009, 7.8% of Medicare fee-for-service claims were paid in error, compared with 3.5% in fiscal year 2008, said the agency in a statement. The CMS said that the increase in the error rate resulted largely from a change in how it identified improper payments. “This year, we made the call to stop calculating our error rate in fee-for-service Medicare the way that the previous administration did and to start using a more rigorous method in calculating this rate in keeping with our mandate to root out errors and fraud,” Health and Human Services Secretary Kathleen Sebelius said in a statement. The CMS said that the higher improper payment rate is not necessarily an indicator of greater fraud. Rather, it was “a more complete accounting of errors,” according to Ms. Sebelius.

Employers Favor Family Plans

Employer contributions to health savings accounts, which are integral to “consumer-driven” health plans, are shifting to favor family-coverage plans, according to the Employee Benefit Research Institute. Workers with employee-only coverage have seen annual employer contributions to their health savings accounts decline, but those with family coverage saw increases in 2009, the institute said. About 4% of Americans have consumer-driven health plans, the report said, and about 63% of employers offering such plans make contributions to their workers' health savings accounts.

Electronic Tools Effective: AHRQ

Consumer health informatics—electronic tools and applications designed to provide tailored health advice to patients—could save money by eliminating the need for some health education activities now performed by clinicians, said a report from the Agency for Healthcare Research and Quality. Health informatics also could improve clinician-patient interactions dealing with a wide variety of diseases and health issues, the AHRQ said. The agency reviewed more than 100 studies of consumers getting health information via the Web, computer programs, and other electronic avenues such as texting and chat groups. The analysis found that the most effective health informatics applications tailor messages using a patients' own health information and provide feedback about the that person's progress as the intervention progresses.

Provider Fraud Most Common

By far, most health care fraud—80%—involves providers systematically overcharging public or private insurers, according to a report from researchers at George Washington University, Washington, and the National Academy for State Health Policy. The study found that these schemes disproportionately target demographic groups likely to be enrolled in Medicare and Medicaid. However, the researchers also found that fraud information concerning the public programs is frequently confused with payment-error data. The authors recommended stronger laws governing insurance marketing, enrollment, claims payments, and antifraud procedures.

DEA Effort Delays Pain Relief

Efforts by the Drug Enforcement Administration to prevent the theft of prescription narcotics are denying pain relief to many nursing home, hospice, and other long-term care patients, two senators said in a letter to Attorney General Eric Holder. Sen. Herb Kohl (D-Wis.), chairman of the Senate Special Committee on Aging, and Sen. Sheldon Whitehouse (D-R.I.) called on Holder to issue new directives to the DEA. The senators proposed legislation that they said could fix the problem. To deter diversion of prescription drugs, the agency stepped up enforcement of laws that require pharmacies to obtain hard copies of prescriptions with signatures from physicians, instead of routine medication orders, for controlled substances prescribed in residential-care settings. This has disrupted “well-established medication coordination protocols” and led to delays in providing those medications to sick patients, the two lawmakers said.

Adverse Event Reports Go Unused

The Food and Drug Administration's Center for Devices and Radiological Health fails to use adverse event reports in a systematic manner to detect and address medical device safety problems, a report from the HHS Office of the Inspector General found. Manufacturers and medical facilities are required to promptly submit reports to the FDA center following adverse events, which can include deaths, serious injuries, and device malfunctions. But the center has no documentation of following up on these events, and it fails to read most reports in a timely fashion, according to the report. Meanwhile, reports of problems with medical devices are increasing, the Inspector General's office found: The FDA center received about 73,000 adverse event reports in 2003 but more than 150,000 in 2007. The Inspector General recommended that the center develop better protocols for reviewing and tracking the reports.

Medicare's Improper Payments

The Centers for Medicare and Medicaid Services made approximately $24 billion in improper payments in fiscal year 2009, an error rate that was almost double the rate of the previous year. In fiscal year 2009, 7.8% of Medicare fee-for-service claims were paid in error, compared with 3.5% in fiscal year 2008, said the agency in a statement. The CMS said that the increase in the error rate resulted largely from a change in how it identified improper payments. “This year, we made the call to stop calculating our error rate in fee-for-service Medicare the way that the previous administration did and to start using a more rigorous method in calculating this rate in keeping with our mandate to root out errors and fraud,” Health and Human Services Secretary Kathleen Sebelius said in a statement. The CMS said that the higher improper payment rate is not necessarily an indicator of greater fraud. Rather, it was “a more complete accounting of errors,” according to Ms. Sebelius.

Employers Favor Family Plans

Employer contributions to health savings accounts, which are integral to “consumer-driven” health plans, are shifting to favor family-coverage plans, according to the Employee Benefit Research Institute. Workers with employee-only coverage have seen annual employer contributions to their health savings accounts decline, but those with family coverage saw increases in 2009, the institute said. About 4% of Americans have consumer-driven health plans, the report said, and about 63% of employers offering such plans make contributions to their workers' health savings accounts.

Electronic Tools Effective: AHRQ

Consumer health informatics—electronic tools and applications designed to provide tailored health advice to patients—could save money by eliminating the need for some health education activities now performed by clinicians, said a report from the Agency for Healthcare Research and Quality. Health informatics also could improve clinician-patient interactions dealing with a wide variety of diseases and health issues, the AHRQ said. The agency reviewed more than 100 studies of consumers getting health information via the Web, computer programs, and other electronic avenues such as texting and chat groups. The analysis found that the most effective health informatics applications tailor messages using a patients' own health information and provide feedback about the that person's progress as the intervention progresses.

Provider Fraud Most Common

By far, most health care fraud—80%—involves providers systematically overcharging public or private insurers, according to a report from researchers at George Washington University, Washington, and the National Academy for State Health Policy. The study found that these schemes disproportionately target demographic groups likely to be enrolled in Medicare and Medicaid. However, the researchers also found that fraud information concerning the public programs is frequently confused with payment-error data. The authors recommended stronger laws governing insurance marketing, enrollment, claims payments, and antifraud procedures.

DEA Effort Delays Pain Relief

Efforts by the Drug Enforcement Administration to prevent the theft of prescription narcotics are denying pain relief to many nursing home, hospice, and other long-term care patients, two senators said in a letter to Attorney General Eric Holder. Sen. Herb Kohl (D-Wis.), chairman of the Senate Special Committee on Aging, and Sen. Sheldon Whitehouse (D-R.I.) called on Holder to issue new directives to the DEA. The senators proposed legislation that they said could fix the problem. To deter diversion of prescription drugs, the agency stepped up enforcement of laws that require pharmacies to obtain hard copies of prescriptions with signatures from physicians, instead of routine medication orders, for controlled substances prescribed in residential-care settings. This has disrupted “well-established medication coordination protocols” and led to delays in providing those medications to sick patients, the two lawmakers said.