Jane Anderson

Family Insurance Tops $12K

Employer-sponsored insurance for a family of four in 2008 cost employers and workers an average of $12,298, according to the Agency for Healthcare Research and Quality. The employees' contribution averaged $3,394 for family-of-four plans and $882 for single workers, the agency reported. Employers paid the entire premium for 22% of workers with single-coverage plans, for 11% of workers with family-of-four plans, and for 9% of employees with one covered family member. About 31 million of the more than 62 million workers enrolled in employer-based insurance in 2008 had single plans, while 20 million had family-of-four coverage.

Information Tech Is Growing

The electronic exchange of health information among physicians, hospitals, health plans, and patients has increased substantially in the past year, the nonprofit group eHealth Initiative (eHI) found in its annual survey of 150 community-based “health information electronically” initiatives. Respondents reported a nearly 40% increase in the number of initiatives that were advanced enough to be exchanging information. According to eHI, these groups said that information technology is cutting redundant tests, avoiding some medication errors, and reducing staff time spent handling lab results and doing clerical tasks. The federal government is to spend at least $300 million on health information technology over the next 2 years as part of the Recovery Act. “We have a great opportunity to expand [health information technology] efforts with the new funding coming out in 2009 and 2010,” said eHI chief operating officer Jennifer Covich in a statement.

HHS Allocates Training Funds

The Department of Health and Human Services has released $200 million to support grants, loans, loan repayments, and scholarships for health care professionals focusing on primary care. According to HHS, the funds will train about 8,000 students and credentialed health professionals by the end of fiscal year 2010. More than $47 million of the funds will support primary care training for residents, medical students, physician assistants, and dentists. Another $10.5 million will support training of other public health workers. Meanwhile, about $80 million will go toward scholarships, loans, and loan-repayment awards, while about $50 million will help various primary care training programs purchase equipment needed to improve their quality and capacity, HHS said. The $200 million is part of $500 million that the federal economic stimulus package allotted for the Health Resources and Services Administration to address health workforce shortages.

Free Rx Program Will Expand

AstraZeneca Pharmaceuticals LP has expanded its prescription drug savings program and will enable people who were recently laid off or have had their incomes reduced to receive free medications more quickly. Previously, some people with recent drops in income or increases in family size had problems applying for free medications because their W2 statements didn't indicate that they qualified. But AstraZeneca said it now will accept documentation showing current income and family size, enabling recently laid-off patients and others to enroll more easily. The AZ&Me Prescription Savings program provides AstraZeneca medicines at no cost to individuals who make up to $30,000 per year and to families of four making up to $60,000 per year, if they have no other prescription drug coverage.

Medicine in Big Easy Isn't

Federal funding has helped provide primary care in the hurricane-pummeled greater New Orleans area, but grant recipients continue to face significant challenges, the Government Accountability Office reported. Primary care providers in the area have had increasing trouble hiring and retaining staff, as well as referring patients outside their practices, the GAO said. In 2007, HHS awarded $100 million in grants to restore primary care for low-income people in the New Orleans area. Grant recipients have used the funds to hire or retain health care providers and other staff and to open new delivery sites in underserved neighborhoods, but it's still not clear how many primary care organizations will survive, the GAO said.

Biosimilars Market: $45 Million

A research firm pegs the U.S. market for generic versions of biotechnology products, called biosimilars or biogenerics, at $45 million by 2015, if the federal government clears a regulatory path for such products. The major health reform bills now making their way through Congress would do so. Kalorama Information said that biosimilars of human growth hormone, insulin, and some protein- and recombinant DNA-based therapies would probably be the first generics available. Early sales aren't likely to be robust, partly because the brand name manufacturers will defend their turf, but a few capable generic makers “will hit the ground running” once approval of biosimilars is granted, said Kalorama's Bruce Carlson in a statement.

Family Insurance Tops $12K

Employer-sponsored insurance for a family of four in 2008 cost employers and workers an average of $12,298, according to the Agency for Healthcare Research and Quality. The employees' contribution averaged $3,394 for family-of-four plans and $882 for single workers, the agency reported. Employers paid the entire premium for 22% of workers with single-coverage plans, for 11% of workers with family-of-four plans, and for 9% of employees with one covered family member. About 31 million of the more than 62 million workers enrolled in employer-based insurance in 2008 had single plans, while 20 million had family-of-four coverage.

Information Tech Is Growing

The electronic exchange of health information among physicians, hospitals, health plans, and patients has increased substantially in the past year, the nonprofit group eHealth Initiative (eHI) found in its annual survey of 150 community-based “health information electronically” initiatives. Respondents reported a nearly 40% increase in the number of initiatives that were advanced enough to be exchanging information. According to eHI, these groups said that information technology is cutting redundant tests, avoiding some medication errors, and reducing staff time spent handling lab results and doing clerical tasks. The federal government is to spend at least $300 million on health information technology over the next 2 years as part of the Recovery Act. “We have a great opportunity to expand [health information technology] efforts with the new funding coming out in 2009 and 2010,” said eHI chief operating officer Jennifer Covich in a statement.

HHS Allocates Training Funds

The Department of Health and Human Services has released $200 million to support grants, loans, loan repayments, and scholarships for health care professionals focusing on primary care. According to HHS, the funds will train about 8,000 students and credentialed health professionals by the end of fiscal year 2010. More than $47 million of the funds will support primary care training for residents, medical students, physician assistants, and dentists. Another $10.5 million will support training of other public health workers. Meanwhile, about $80 million will go toward scholarships, loans, and loan-repayment awards, while about $50 million will help various primary care training programs purchase equipment needed to improve their quality and capacity, HHS said. The $200 million is part of $500 million that the federal economic stimulus package allotted for the Health Resources and Services Administration to address health workforce shortages.

Free Rx Program Will Expand

AstraZeneca Pharmaceuticals LP has expanded its prescription drug savings program and will enable people who were recently laid off or have had their incomes reduced to receive free medications more quickly. Previously, some people with recent drops in income or increases in family size had problems applying for free medications because their W2 statements didn't indicate that they qualified. But AstraZeneca said it now will accept documentation showing current income and family size, enabling recently laid-off patients and others to enroll more easily. The AZ&Me Prescription Savings program provides AstraZeneca medicines at no cost to individuals who make up to $30,000 per year and to families of four making up to $60,000 per year, if they have no other prescription drug coverage.

Medicine in Big Easy Isn't

Federal funding has helped provide primary care in the hurricane-pummeled greater New Orleans area, but grant recipients continue to face significant challenges, the Government Accountability Office reported. Primary care providers in the area have had increasing trouble hiring and retaining staff, as well as referring patients outside their practices, the GAO said. In 2007, HHS awarded $100 million in grants to restore primary care for low-income people in the New Orleans area. Grant recipients have used the funds to hire or retain health care providers and other staff and to open new delivery sites in underserved neighborhoods, but it's still not clear how many primary care organizations will survive, the GAO said.

Biosimilars Market: $45 Million

A research firm pegs the U.S. market for generic versions of biotechnology products, called biosimilars or biogenerics, at $45 million by 2015, if the federal government clears a regulatory path for such products. The major health reform bills now making their way through Congress would do so. Kalorama Information said that biosimilars of human growth hormone, insulin, and some protein- and recombinant DNA-based therapies would probably be the first generics available. Early sales aren't likely to be robust, partly because the brand name manufacturers will defend their turf, but a few capable generic makers “will hit the ground running” once approval of biosimilars is granted, said Kalorama's Bruce Carlson in a statement.

Family Insurance Tops $12K

Employer-sponsored insurance for a family of four in 2008 cost employers and workers an average of $12,298, according to the Agency for Healthcare Research and Quality. The employees' contribution averaged $3,394 for family-of-four plans and $882 for single workers, the agency reported. Employers paid the entire premium for 22% of workers with single-coverage plans, for 11% of workers with family-of-four plans, and for 9% of employees with one covered family member. About 31 million of the more than 62 million workers enrolled in employer-based insurance in 2008 had single plans, while 20 million had family-of-four coverage.

Information Tech Is Growing

The electronic exchange of health information among physicians, hospitals, health plans, and patients has increased substantially in the past year, the nonprofit group eHealth Initiative (eHI) found in its annual survey of 150 community-based “health information electronically” initiatives. Respondents reported a nearly 40% increase in the number of initiatives that were advanced enough to be exchanging information. According to eHI, these groups said that information technology is cutting redundant tests, avoiding some medication errors, and reducing staff time spent handling lab results and doing clerical tasks. The federal government is to spend at least $300 million on health information technology over the next 2 years as part of the Recovery Act. “We have a great opportunity to expand [health information technology] efforts with the new funding coming out in 2009 and 2010,” said eHI chief operating officer Jennifer Covich in a statement.

HHS Allocates Training Funds

The Department of Health and Human Services has released $200 million to support grants, loans, loan repayments, and scholarships for health care professionals focusing on primary care. According to HHS, the funds will train about 8,000 students and credentialed health professionals by the end of fiscal year 2010. More than $47 million of the funds will support primary care training for residents, medical students, physician assistants, and dentists. Another $10.5 million will support training of other public health workers. Meanwhile, about $80 million will go toward scholarships, loans, and loan-repayment awards, while about $50 million will help various primary care training programs purchase equipment needed to improve their quality and capacity, HHS said. The $200 million is part of $500 million that the federal economic stimulus package allotted for the Health Resources and Services Administration to address health workforce shortages.

Free Rx Program Will Expand

AstraZeneca Pharmaceuticals LP has expanded its prescription drug savings program and will enable people who were recently laid off or have had their incomes reduced to receive free medications more quickly. Previously, some people with recent drops in income or increases in family size had problems applying for free medications because their W2 statements didn't indicate that they qualified. But AstraZeneca said it now will accept documentation showing current income and family size, enabling recently laid-off patients and others to enroll more easily. The AZ&Me Prescription Savings program provides AstraZeneca medicines at no cost to individuals who make up to $30,000 per year and to families of four making up to $60,000 per year, if they have no other prescription drug coverage.

Medicine in Big Easy Isn't

Federal funding has helped provide primary care in the hurricane-pummeled greater New Orleans area, but grant recipients continue to face significant challenges, the Government Accountability Office reported. Primary care providers in the area have had increasing trouble hiring and retaining staff, as well as referring patients outside their practices, the GAO said. In 2007, HHS awarded $100 million in grants to restore primary care for low-income people in the New Orleans area. Grant recipients have used the funds to hire or retain health care providers and other staff and to open new delivery sites in underserved neighborhoods, but it's still not clear how many primary care organizations will survive, the GAO said.

Biosimilars Market: $45 Million

A research firm pegs the U.S. market for generic versions of biotechnology products, called biosimilars or biogenerics, at $45 million by 2015, if the federal government clears a regulatory path for such products. The major health reform bills now making their way through Congress would do so. Kalorama Information said that biosimilars of human growth hormone, insulin, and some protein- and recombinant DNA-based therapies would probably be the first generics available. Early sales aren't likely to be robust, partly because the brand name manufacturers will defend their turf, but a few capable generic makers “will hit the ground running” once approval of biosimilars is granted, said Kalorama's Bruce Carlson in a statement.

Family Insurance Tops $12K

Employer-sponsored insurance for a family of four in 2008 cost employers and workers an average of $12,298, according to the Agency for Healthcare Research and Quality. The employees' contribution averaged $3,394 for family-of-four plans and $882 for single workers, the agency reported. Employers paid the entire premium for 22% of workers with single-coverage plans, for 11% of workers with family-of-four plans, and for 9% of employees with one covered family member. About 31 million of the more than 62 million workers enrolled in employer-based insurance in 2008 had single plans, while 20 million had family-of-four coverage.

Information Tech Is Growing

The electronic exchange of health information among physicians, hospitals, health plans, and patients has increased substantially in the past year, the nonprofit group eHealth Initiative (eHI) found in its annual survey of 150 community-based “health information electronically” initiatives. Respondents reported a nearly 40% increase in the number of initiatives that were advanced enough to be exchanging information. According to eHI, these groups said that information technology is cutting redundant tests, avoiding some medication errors, and reducing staff time spent handling lab results and doing clerical tasks. The federal government is to spend at least $300 million on health information technology over the next 2 years as part of the American Recovery and Reinvestment Act of 2009.

HHS Allocates Training Funds

The Department of Health and Human Services has released $200 million to support grants, loans, loan repayments, and scholarships for health care professionals focusing on primary care. According to the HHS, the funds will train about 8,000 students and credentialed health professionals by the end of fiscal year 2010. More than $47 million of the funds will support primary care training for residents, medical students, physician assistants, and dentists. Another $10.5 million will support training of other public health workers. Meanwhile, about $80 million will go toward scholarships, loans, and loan-repayment awards, while about $50 million will help various primary care training programs purchase equipment needed to improve their quality and capacity. Some funds also will go to increasing racial diversity in the workforce and to reducing barriers to telemedicine, the HHS said. The $200 million is part of $500 million that the federal economic stimulus package allotted for the Health Resources and Services Administration to address health workforce shortages.

Free Rx Program Will Expand

AstraZeneca Pharmaceuticals LP has expanded its prescription drug savings program and will enable people who were recently laid off or have had their incomes reduced to receive free medications more quickly. The program also will help more patients who have experienced changes in marital status or family size, the drug maker said. Previously, some people with recent drops in income or increases in family size had problems applying for free medications because their W2 statements didn't indicate that they qualified. But AstraZeneca said it now will accept other documentation showing current income and family size. The AZ&Me Prescription Savings program provides AstraZeneca medicines at no cost to individuals who make up to $30,000 per year and to families of four making up to $60,000 per year, if they have no other prescription drug coverage.

Medicine in Big Easy Isn't

Federal funding has helped provide primary care in the hurricane-pummeled greater New Orleans area, but grant recipients continue to face significant challenges, the Government Accountability Office reported. Primary care providers in the area have had increasing trouble hiring and retaining staff, as well as referring patients outside their practices, the GAO said. In 2007, the HHS awarded $100 million in grants to restore primary care for low-income people in the New Orleans area. Grant recipients have used the funds to hire or retain staff, to add primary care services, and to open new delivery sites in underserved neighborhoods. However, it's still not clear how many of the primary care organizations will survive, the GAO said.

Biosimilars Market: $45 Million

A research firm pegs the U.S. market for generic versions of biotechnology products, called biosimilars or biogenerics, at $45 million by 2015 if the federal government clears a regulatory path for such products. The major health reform bills now making their way through Congress would do so. Kalorama Information said that biosimilars of human growth hormone, insulin, and some protein- and recombinant DNA-based therapies would probably be the first generics available. Early sales aren't likely to be robust, partly because the brand-name manufacturers will defend their turf, the Kalorama report predicted. Nevertheless, a few generic makers “will hit the ground running” once approval of biosimilars is granted, Kalorama's Bruce Carlson said in a statement.

Family Insurance Tops $12K

Employer-sponsored insurance for a family of four in 2008 cost employers and workers an average of $12,298, according to the Agency for Healthcare Research and Quality. The employees' contribution averaged $3,394 for family-of-four plans and $882 for single workers, the agency reported. Employers paid the entire premium for 22% of workers with single-coverage plans, for 11% of workers with family-of-four plans, and for 9% of employees with one covered family member. About 31 million of the more than 62 million workers enrolled in employer-based insurance in 2008 had single plans, while 20 million had family-of-four coverage.

Information Tech Is Growing

The electronic exchange of health information among physicians, hospitals, health plans, and patients has increased substantially in the past year, the nonprofit group eHealth Initiative (eHI) found in its annual survey of 150 community-based “health information electronically” initiatives. Respondents reported a nearly 40% increase in the number of initiatives that were advanced enough to be exchanging information. According to eHI, these groups said that information technology is cutting redundant tests, avoiding some medication errors, and reducing staff time spent handling lab results and doing clerical tasks. The federal government is to spend at least $300 million on health information technology over the next 2 years as part of the American Recovery and Reinvestment Act of 2009.

HHS Allocates Training Funds

The Department of Health and Human Services has released $200 million to support grants, loans, loan repayments, and scholarships for health care professionals focusing on primary care. According to the HHS, the funds will train about 8,000 students and credentialed health professionals by the end of fiscal year 2010. More than $47 million of the funds will support primary care training for residents, medical students, physician assistants, and dentists. Another $10.5 million will support training of other public health workers. Meanwhile, about $80 million will go toward scholarships, loans, and loan-repayment awards, while about $50 million will help various primary care training programs purchase equipment needed to improve their quality and capacity. Some funds also will go to increasing racial diversity in the workforce and to reducing barriers to telemedicine, the HHS said. The $200 million is part of $500 million that the federal economic stimulus package allotted for the Health Resources and Services Administration to address health workforce shortages.

Free Rx Program Will Expand

AstraZeneca Pharmaceuticals LP has expanded its prescription drug savings program and will enable people who were recently laid off or have had their incomes reduced to receive free medications more quickly. The program also will help more patients who have experienced changes in marital status or family size, the drug maker said. Previously, some people with recent drops in income or increases in family size had problems applying for free medications because their W2 statements didn't indicate that they qualified. But AstraZeneca said it now will accept other documentation showing current income and family size. The AZ&Me Prescription Savings program provides AstraZeneca medicines at no cost to individuals who make up to $30,000 per year and to families of four making up to $60,000 per year, if they have no other prescription drug coverage.

Medicine in Big Easy Isn't

Federal funding has helped provide primary care in the hurricane-pummeled greater New Orleans area, but grant recipients continue to face significant challenges, the Government Accountability Office reported. Primary care providers in the area have had increasing trouble hiring and retaining staff, as well as referring patients outside their practices, the GAO said. In 2007, the HHS awarded $100 million in grants to restore primary care for low-income people in the New Orleans area. Grant recipients have used the funds to hire or retain staff, to add primary care services, and to open new delivery sites in underserved neighborhoods. However, it's still not clear how many of the primary care organizations will survive, the GAO said.

Biosimilars Market: $45 Million

A research firm pegs the U.S. market for generic versions of biotechnology products, called biosimilars or biogenerics, at $45 million by 2015 if the federal government clears a regulatory path for such products. The major health reform bills now making their way through Congress would do so. Kalorama Information said that biosimilars of human growth hormone, insulin, and some protein- and recombinant DNA-based therapies would probably be the first generics available. Early sales aren't likely to be robust, partly because the brand-name manufacturers will defend their turf, the Kalorama report predicted. Nevertheless, a few generic makers “will hit the ground running” once approval of biosimilars is granted, Kalorama's Bruce Carlson said in a statement.

Family Insurance Tops $12K

Employer-sponsored insurance for a family of four in 2008 cost employers and workers an average of $12,298, according to the Agency for Healthcare Research and Quality. The employees' contribution averaged $3,394 for family-of-four plans and $882 for single workers, the agency reported. Employers paid the entire premium for 22% of workers with single-coverage plans, for 11% of workers with family-of-four plans, and for 9% of employees with one covered family member. About 31 million of the more than 62 million workers enrolled in employer-based insurance in 2008 had single plans, while 20 million had family-of-four coverage.

Information Tech Is Growing

The electronic exchange of health information among physicians, hospitals, health plans, and patients has increased substantially in the past year, the nonprofit group eHealth Initiative (eHI) found in its annual survey of 150 community-based “health information electronically” initiatives. Respondents reported a nearly 40% increase in the number of initiatives that were advanced enough to be exchanging information. According to eHI, these groups said that information technology is cutting redundant tests, avoiding some medication errors, and reducing staff time spent handling lab results and doing clerical tasks. The federal government is to spend at least $300 million on health information technology over the next 2 years as part of the American Recovery and Reinvestment Act of 2009.

HHS Allocates Training Funds

The Department of Health and Human Services has released $200 million to support grants, loans, loan repayments, and scholarships for health care professionals focusing on primary care. According to the HHS, the funds will train about 8,000 students and credentialed health professionals by the end of fiscal year 2010. More than $47 million of the funds will support primary care training for residents, medical students, physician assistants, and dentists. Another $10.5 million will support training of other public health workers. Meanwhile, about $80 million will go toward scholarships, loans, and loan-repayment awards, while about $50 million will help various primary care training programs purchase equipment needed to improve their quality and capacity. Some funds also will go to increasing racial diversity in the workforce and to reducing barriers to telemedicine, the HHS said. The $200 million is part of $500 million that the federal economic stimulus package allotted for the Health Resources and Services Administration to address health workforce shortages.

Free Rx Program Will Expand

AstraZeneca Pharmaceuticals LP has expanded its prescription drug savings program and will enable people who were recently laid off or have had their incomes reduced to receive free medications more quickly. The program also will help more patients who have experienced changes in marital status or family size, the drug maker said. Previously, some people with recent drops in income or increases in family size had problems applying for free medications because their W2 statements didn't indicate that they qualified. But AstraZeneca said it now will accept other documentation showing current income and family size. The AZ&Me Prescription Savings program provides AstraZeneca medicines at no cost to individuals who make up to $30,000 per year and to families of four making up to $60,000 per year, if they have no other prescription drug coverage.

Medicine in Big Easy Isn't

Federal funding has helped provide primary care in the hurricane-pummeled greater New Orleans area, but grant recipients continue to face significant challenges, the Government Accountability Office reported. Primary care providers in the area have had increasing trouble hiring and retaining staff, as well as referring patients outside their practices, the GAO said. In 2007, the HHS awarded $100 million in grants to restore primary care for low-income people in the New Orleans area. Grant recipients have used the funds to hire or retain staff, to add primary care services, and to open new delivery sites in underserved neighborhoods. However, it's still not clear how many of the primary care organizations will survive, the GAO said.

Biosimilars Market: $45 Million

A research firm pegs the U.S. market for generic versions of biotechnology products, called biosimilars or biogenerics, at $45 million by 2015 if the federal government clears a regulatory path for such products. The major health reform bills now making their way through Congress would do so. Kalorama Information said that biosimilars of human growth hormone, insulin, and some protein- and recombinant DNA-based therapies would probably be the first generics available. Early sales aren't likely to be robust, partly because the brand-name manufacturers will defend their turf, the Kalorama report predicted. Nevertheless, a few generic makers “will hit the ground running” once approval of biosimilars is granted, Kalorama's Bruce Carlson said in a statement.

egmnblog.wordpress.com

Court Reverses Vaccine Decision

The U.S. Court of Appeals for the Federal Circuit has reversed a ruling that had denied compensation to a child who declined after a diptheria, whole-cell pertussis, and tetanus (DPT) vaccination. Enrique Andreu was 8 weeks old and developing normally when he was inoculated with the vaccine. He began to suffer seizures 1 day after receiving the shot. Enrique ultimately was diagnosed with language and developmental delays and a low IQ. His pediatric neurologist told the federal vaccine court, which heard the case first, that there was “no other explanation other than the DPT immunization.” But the vaccine court denied the claim, and the U.S. Court of Federal Claims concurred. However, the federal circuit appeals court has now ruled that the boy is entitled to compensation for his vaccine injury. The court sent the case back to the federal claims court with instructions to determine how much compensation Enrique should receive.

New York Fined on Medicaid

The state of New York and New York City have agreed to pay a record $540 million to settle Medicaid false claims allegations, the federal Justice Department said. The false claims were for reimbursement for school-based health care services, mostly speech therapy and transportation, between 1990 and 2001. According to Justice, New York state failed to provide proper guidance to school districts and counties on which services should be reimbursed under Medicaid. The state also passed on claims to the federal government for services it knew were not covered or properly documented, thus getting the federal government to pay more of its share of New York Medicaid costs than it should have, the settlement said. Meanwhile, New York City submitted claims to the state for false speech services, and the state passed those claims on to the federal government, Justice said. New York state will pay $440 million, while New York City will pay $100 million.

Child Injuries: Many From Sports

Sports-related injuries such as bruises, scrapes, and broken bones accounted for about one-fifth of hospital emergency department visits for children aged 5-17 in 2006, according to the Agency for Healthcare Research and Quality. Boys had three times as many ED visits for sports injuries as girls did, and teens were five times as likely as younger children to be treated for sports injuries in EDs, according to AHRQ. Four out of five visits for sports injuries were for treatment of bruises, sprains and strains, arm fractures, or cuts and scrapes to the head, neck, or chest, the report said. Almost all children were treated and released: Only 1.3% of visits resulted in hospital admissions.

Child Obesity May Be Stabilizing

One in seven low-income, preschool-aged children is obese, but the obesity epidemic may be moderating, the Centers for Disease Control and Prevention found in a study. The prevalence of obesity in low-income 2- to 4-year-olds increased from about 12% in 1998 to more than 14% in 2003 but rose much less between 2003 and 2008. Obesity prevalence for low-income preschoolers has remained constant or declined since 2003 in about half of the states, territories, and tribal organizations monitored by the CDC, although rates in American Indian and Alaska Native children continued to rise. A second study published in Health Affairs reported that hospitalizations of children and youth with a diagnosis of obesity nearly doubled between 1999 and 2005, indicating that social and economic costs of pediatric obesity are increasing even as prevalence is stabilizing.

$40 Million Will Expand CHIP

The Department of Health and Human Services is making available up to $40 million in grants to programs for families whose children qualify for states' Medicaid programs and Children's Health Insurance Program. The funds are part of the CHIP reauthorization approved earlier this year. The grants will fund projects ranging from grassroots efforts to reach more eligible children to technology-driven initiatives to modernize and streamline enrollment systems. “We know there are millions of children who are eligible for coverage but don't utilize their state health care programs,” said HHS Secretary Kathleen Sebelius.

egmnblog.wordpress.com

Court Reverses Vaccine Decision

The U.S. Court of Appeals for the Federal Circuit has reversed a ruling that had denied compensation to a child who declined after a diptheria, whole-cell pertussis, and tetanus (DPT) vaccination. Enrique Andreu was 8 weeks old and developing normally when he was inoculated with the vaccine. He began to suffer seizures 1 day after receiving the shot. Enrique ultimately was diagnosed with language and developmental delays and a low IQ. His pediatric neurologist told the federal vaccine court, which heard the case first, that there was “no other explanation other than the DPT immunization.” But the vaccine court denied the claim, and the U.S. Court of Federal Claims concurred. However, the federal circuit appeals court has now ruled that the boy is entitled to compensation for his vaccine injury. The court sent the case back to the federal claims court with instructions to determine how much compensation Enrique should receive.

New York Fined on Medicaid

The state of New York and New York City have agreed to pay a record $540 million to settle Medicaid false claims allegations, the federal Justice Department said. The false claims were for reimbursement for school-based health care services, mostly speech therapy and transportation, between 1990 and 2001. According to Justice, New York state failed to provide proper guidance to school districts and counties on which services should be reimbursed under Medicaid. The state also passed on claims to the federal government for services it knew were not covered or properly documented, thus getting the federal government to pay more of its share of New York Medicaid costs than it should have, the settlement said. Meanwhile, New York City submitted claims to the state for false speech services, and the state passed those claims on to the federal government, Justice said. New York state will pay $440 million, while New York City will pay $100 million.

Child Injuries: Many From Sports

Sports-related injuries such as bruises, scrapes, and broken bones accounted for about one-fifth of hospital emergency department visits for children aged 5-17 in 2006, according to the Agency for Healthcare Research and Quality. Boys had three times as many ED visits for sports injuries as girls did, and teens were five times as likely as younger children to be treated for sports injuries in EDs, according to AHRQ. Four out of five visits for sports injuries were for treatment of bruises, sprains and strains, arm fractures, or cuts and scrapes to the head, neck, or chest, the report said. Almost all children were treated and released: Only 1.3% of visits resulted in hospital admissions.

Child Obesity May Be Stabilizing

One in seven low-income, preschool-aged children is obese, but the obesity epidemic may be moderating, the Centers for Disease Control and Prevention found in a study. The prevalence of obesity in low-income 2- to 4-year-olds increased from about 12% in 1998 to more than 14% in 2003 but rose much less between 2003 and 2008. Obesity prevalence for low-income preschoolers has remained constant or declined since 2003 in about half of the states, territories, and tribal organizations monitored by the CDC, although rates in American Indian and Alaska Native children continued to rise. A second study published in Health Affairs reported that hospitalizations of children and youth with a diagnosis of obesity nearly doubled between 1999 and 2005, indicating that social and economic costs of pediatric obesity are increasing even as prevalence is stabilizing.

$40 Million Will Expand CHIP

The Department of Health and Human Services is making available up to $40 million in grants to programs for families whose children qualify for states' Medicaid programs and Children's Health Insurance Program. The funds are part of the CHIP reauthorization approved earlier this year. The grants will fund projects ranging from grassroots efforts to reach more eligible children to technology-driven initiatives to modernize and streamline enrollment systems. “We know there are millions of children who are eligible for coverage but don't utilize their state health care programs,” said HHS Secretary Kathleen Sebelius.

egmnblog.wordpress.com

Court Reverses Vaccine Decision

The U.S. Court of Appeals for the Federal Circuit has reversed a ruling that had denied compensation to a child who declined after a diptheria, whole-cell pertussis, and tetanus (DPT) vaccination. Enrique Andreu was 8 weeks old and developing normally when he was inoculated with the vaccine. He began to suffer seizures 1 day after receiving the shot. Enrique ultimately was diagnosed with language and developmental delays and a low IQ. His pediatric neurologist told the federal vaccine court, which heard the case first, that there was “no other explanation other than the DPT immunization.” But the vaccine court denied the claim, and the U.S. Court of Federal Claims concurred. However, the federal circuit appeals court has now ruled that the boy is entitled to compensation for his vaccine injury. The court sent the case back to the federal claims court with instructions to determine how much compensation Enrique should receive.

New York Fined on Medicaid

The state of New York and New York City have agreed to pay a record $540 million to settle Medicaid false claims allegations, the federal Justice Department said. The false claims were for reimbursement for school-based health care services, mostly speech therapy and transportation, between 1990 and 2001. According to Justice, New York state failed to provide proper guidance to school districts and counties on which services should be reimbursed under Medicaid. The state also passed on claims to the federal government for services it knew were not covered or properly documented, thus getting the federal government to pay more of its share of New York Medicaid costs than it should have, the settlement said. Meanwhile, New York City submitted claims to the state for false speech services, and the state passed those claims on to the federal government, Justice said. New York state will pay $440 million, while New York City will pay $100 million.

Child Injuries: Many From Sports

Sports-related injuries such as bruises, scrapes, and broken bones accounted for about one-fifth of hospital emergency department visits for children aged 5-17 in 2006, according to the Agency for Healthcare Research and Quality. Boys had three times as many ED visits for sports injuries as girls did, and teens were five times as likely as younger children to be treated for sports injuries in EDs, according to AHRQ. Four out of five visits for sports injuries were for treatment of bruises, sprains and strains, arm fractures, or cuts and scrapes to the head, neck, or chest, the report said. Almost all children were treated and released: Only 1.3% of visits resulted in hospital admissions.

Child Obesity May Be Stabilizing

One in seven low-income, preschool-aged children is obese, but the obesity epidemic may be moderating, the Centers for Disease Control and Prevention found in a study. The prevalence of obesity in low-income 2- to 4-year-olds increased from about 12% in 1998 to more than 14% in 2003 but rose much less between 2003 and 2008. Obesity prevalence for low-income preschoolers has remained constant or declined since 2003 in about half of the states, territories, and tribal organizations monitored by the CDC, although rates in American Indian and Alaska Native children continued to rise. A second study published in Health Affairs reported that hospitalizations of children and youth with a diagnosis of obesity nearly doubled between 1999 and 2005, indicating that social and economic costs of pediatric obesity are increasing even as prevalence is stabilizing.

$40 Million Will Expand CHIP

The Department of Health and Human Services is making available up to $40 million in grants to programs for families whose children qualify for states' Medicaid programs and Children's Health Insurance Program. The funds are part of the CHIP reauthorization approved earlier this year. The grants will fund projects ranging from grassroots efforts to reach more eligible children to technology-driven initiatives to modernize and streamline enrollment systems. “We know there are millions of children who are eligible for coverage but don't utilize their state health care programs,” said HHS Secretary Kathleen Sebelius.

Although demand for many medical specialists remains strong, group practices and hospitals are focused on recruiting family physicians, general internists, hospitalists, pediatricians, and psychiatrists, according to a review of physician recruitment.

In “2009 Review of Physician Recruiting Incentives,” the physician-search firm Merritt Hawkins & Associates notes that in the past year it handled more requests for family physicians than for any other specialty type. Requests for primary care physicians between April 2008 and March 2009 increased 23% over the previous year, the Irving, Tex.-based company said. It added that although insurers and government programs are increasing their focus on primary care, fewer physicians in training are choosing to be generalists.

A spokeswoman for the Medical Group Management Association agreed that primary care physicians are in higher demand than other specialties. She added, however, that MGMA's own surveys show that increases in primary care physicians' incomes overall haven't been beating inflation.

However, the review by Merritt Hawkins, which tracks over 3,200 physician recruiting assignments, found that salaries offered to newly recruited physicians reflect the increased demand. According to the company, the average salary or income guarantee offered to family physicians jumped 19 percent in the past 3 years, to $173,000; the average offered to general internists rose 15 percent, to $186,000; and the average for pediatricians increased 13 percent, to $171,000.

David Nyman, manager of physician recruitment at the Marshfield Clinic in Wisconsin, said in an interview that the disparities between salary figures in the MGMA and Merritt Hawkins reports can be explained by the different groups of physicians involved. Merritt Hawkins tends to take on the “harder” recruitment assignments and therefore can wind up paying physicians more than the average, he said.

Mr. Nyman added that he's seen an increase in the number of groups willing to help new physicians with their student loans as an incentive to sign on. Groups are well aware that few physicians are going into primary care these days, which is driving increased recruitment of generalists, Nyman said. “People are adding primary physicians now, anticipating that it's going to be more difficult to find them down the road,” he said.

“Virtually every hospital or large medical group in the United States would be happy to add a family physician or general internist,” said Merritt Hawkins' president, Mark Smith, in a statement. “There simply are not enough primary care doctors to go around.”

Demand is also robust for hospitalists, the report said, and that may be hurting primary care. Because many internists are choosing to practice as hospitalists, the supply of physicians for general internal medicine has been constrained, the report concluded.

Meanwhile, demand is strong for various specialists, particularly general surgeons, the Merritt Hawkins report found. General surgeons are becoming increasingly hard to recruit because fewer medical school graduates who choose surgery are opting for the full range of that specialty, the report said.

More than 40 percent of general surgeons are 55 or older and many are retiring, the report said. Merritt Hawkins said it conducted nearly twice as many general surgery searches for clients in 2008-2009 as it did the previous year.

Psychiatry faces a similar situation, the report said, with demand for psychiatrists strong and many practicing psychiatrists near retirement. Other specialty areas experiencing robust demand include orthopedic surgery, obstetrics/gynecology, cardiology, urology, pulmonology, gastroenterology, otolaryngology, hematology/oncology, dermatology, neurology, and emergency medicine.

The search firm reported that 85% of all physicians were offered signing bonuses in 2008-2009, compared with just 58% 3 years ago. The average signing bonus offered to all physicians last year was $24,850.

Although demand for many medical specialists remains strong, group practices and hospitals are focused on recruiting family physicians, general internists, hospitalists, pediatricians, and psychiatrists, according to a review of physician recruitment.

In “2009 Review of Physician Recruiting Incentives,” the physician-search firm Merritt Hawkins & Associates notes that in the past year it handled more requests for family physicians than for any other specialty type. Requests for primary care physicians between April 2008 and March 2009 increased 23% over the previous year, the Irving, Tex.-based company said. It added that although insurers and government programs are increasing their focus on primary care, fewer physicians in training are choosing to be generalists.

A spokeswoman for the Medical Group Management Association agreed that primary care physicians are in higher demand than other specialties. She added, however, that MGMA's own surveys show that increases in primary care physicians' incomes overall haven't been beating inflation.

However, the review by Merritt Hawkins, which tracks over 3,200 physician recruiting assignments, found that salaries offered to newly recruited physicians reflect the increased demand. According to the company, the average salary or income guarantee offered to family physicians jumped 19 percent in the past 3 years, to $173,000; the average offered to general internists rose 15 percent, to $186,000; and the average for pediatricians increased 13 percent, to $171,000.

David Nyman, manager of physician recruitment at the Marshfield Clinic in Wisconsin, said in an interview that the disparities between salary figures in the MGMA and Merritt Hawkins reports can be explained by the different groups of physicians involved. Merritt Hawkins tends to take on the “harder” recruitment assignments and therefore can wind up paying physicians more than the average, he said.

Mr. Nyman added that he's seen an increase in the number of groups willing to help new physicians with their student loans as an incentive to sign on. Groups are well aware that few physicians are going into primary care these days, which is driving increased recruitment of generalists, Nyman said. “People are adding primary physicians now, anticipating that it's going to be more difficult to find them down the road,” he said.

“Virtually every hospital or large medical group in the United States would be happy to add a family physician or general internist,” said Merritt Hawkins' president, Mark Smith, in a statement. “There simply are not enough primary care doctors to go around.”

Demand is also robust for hospitalists, the report said, and that may be hurting primary care. Because many internists are choosing to practice as hospitalists, the supply of physicians for general internal medicine has been constrained, the report concluded.

Meanwhile, demand is strong for various specialists, particularly general surgeons, the Merritt Hawkins report found. General surgeons are becoming increasingly hard to recruit because fewer medical school graduates who choose surgery are opting for the full range of that specialty, the report said.

More than 40 percent of general surgeons are 55 or older and many are retiring, the report said. Merritt Hawkins said it conducted nearly twice as many general surgery searches for clients in 2008-2009 as it did the previous year.

Psychiatry faces a similar situation, the report said, with demand for psychiatrists strong and many practicing psychiatrists near retirement. Other specialty areas experiencing robust demand include orthopedic surgery, obstetrics/gynecology, cardiology, urology, pulmonology, gastroenterology, otolaryngology, hematology/oncology, dermatology, neurology, and emergency medicine.

The search firm reported that 85% of all physicians were offered signing bonuses in 2008-2009, compared with just 58% 3 years ago. The average signing bonus offered to all physicians last year was $24,850.

Although demand for many medical specialists remains strong, group practices and hospitals are focused on recruiting family physicians, general internists, hospitalists, pediatricians, and psychiatrists, according to a review of physician recruitment.

In “2009 Review of Physician Recruiting Incentives,” the physician-search firm Merritt Hawkins & Associates notes that in the past year it handled more requests for family physicians than for any other specialty type. Requests for primary care physicians between April 2008 and March 2009 increased 23% over the previous year, the Irving, Tex.-based company said. It added that although insurers and government programs are increasing their focus on primary care, fewer physicians in training are choosing to be generalists.

A spokeswoman for the Medical Group Management Association agreed that primary care physicians are in higher demand than other specialties. She added, however, that MGMA's own surveys show that increases in primary care physicians' incomes overall haven't been beating inflation.

However, the review by Merritt Hawkins, which tracks over 3,200 physician recruiting assignments, found that salaries offered to newly recruited physicians reflect the increased demand. According to the company, the average salary or income guarantee offered to family physicians jumped 19 percent in the past 3 years, to $173,000; the average offered to general internists rose 15 percent, to $186,000; and the average for pediatricians increased 13 percent, to $171,000.

David Nyman, manager of physician recruitment at the Marshfield Clinic in Wisconsin, said in an interview that the disparities between salary figures in the MGMA and Merritt Hawkins reports can be explained by the different groups of physicians involved. Merritt Hawkins tends to take on the “harder” recruitment assignments and therefore can wind up paying physicians more than the average, he said.

Mr. Nyman added that he's seen an increase in the number of groups willing to help new physicians with their student loans as an incentive to sign on. Groups are well aware that few physicians are going into primary care these days, which is driving increased recruitment of generalists, Nyman said. “People are adding primary physicians now, anticipating that it's going to be more difficult to find them down the road,” he said.

“Virtually every hospital or large medical group in the United States would be happy to add a family physician or general internist,” said Merritt Hawkins' president, Mark Smith, in a statement. “There simply are not enough primary care doctors to go around.”

Demand is also robust for hospitalists, the report said, and that may be hurting primary care. Because many internists are choosing to practice as hospitalists, the supply of physicians for general internal medicine has been constrained, the report concluded.

Meanwhile, demand is strong for various specialists, particularly general surgeons, the Merritt Hawkins report found. General surgeons are becoming increasingly hard to recruit because fewer medical school graduates who choose surgery are opting for the full range of that specialty, the report said.

More than 40 percent of general surgeons are 55 or older and many are retiring, the report said. Merritt Hawkins said it conducted nearly twice as many general surgery searches for clients in 2008-2009 as it did the previous year.

Psychiatry faces a similar situation, the report said, with demand for psychiatrists strong and many practicing psychiatrists near retirement. Other specialty areas experiencing robust demand include orthopedic surgery, obstetrics/gynecology, cardiology, urology, pulmonology, gastroenterology, otolaryngology, hematology/oncology, dermatology, neurology, and emergency medicine.

The search firm reported that 85% of all physicians were offered signing bonuses in 2008-2009, compared with just 58% 3 years ago. The average signing bonus offered to all physicians last year was $24,850.

egmnblog.wordpress.com

Hospitals OK Cuts for Reform

Three major hospital organizations, including the American Hospital Association, have agreed to accept $155 billion in reimbursement cuts for hospitals over the next 10 years as part of health care reform legislation. In a deal negotiated by key Senate lawmakers and announced by Vice President Joe Biden, hospitals would see reductions in their Medicare and Medicaid fees, in addition to $50 billion in cuts in the programs that help pay for care to the uninsured. Some of the cuts would take effect only if reform reduces the uninsured population. The AHA suggested that the deal was as far as hospitals could go: Reimbursement couldn't be cut further “without damaging hospitals' ability to care for their communities.” And two groups that didn't take part in the negotiations, representing public hospitals and children's hospitals, warned that cuts—if not carefully crafted—could hurt institutions caring for large numbers of Medicaid patients.

FDA Seeks Tobacco Comments

The Food and Drug Administration wants public input on how to implement its new authority to regulate tobacco products. In a Federal Register notice, the FDA said it will rely on the public comments when implementing the new Family Smoking Prevention and Tobacco Control Act and when establishing the FDA Center for Tobacco Products. The agency said it's particularly interested in suggestions for reducing tobacco use and protecting public health, but that remarks on any aspect of its new regulatory authority are welcome. Comments will be accepted until Sept. 29, and all will be posted online. They may be submitted at

www.regulations.gov

Malpractice Payments Are Down

Medical malpractice payments were at record low levels in 2008, according to an analysis by the consumer-advocacy group Public Citizen. For the third straight year, 2008 saw the lowest number of malpractice payments since the federal government's National Practitioner Data Bank began tracking such data in 1990, the group said. The data showed that 11,037 payments were made last year, which Public Citizen said was nearly one-third lower than the historical average. The monetary value of payments was either the lowest or second-lowest since 1990, depending on how inflation was calculated, the group said. The total cost of all malpractice insurance premiums fell to much less than 1% of the total $2.1 trillion in annual health costs in 2006 (the most recent year for which full data were available). The cost of actual malpractice payments to patients fell to 0.2% of overall health costs, the group said. David Arkush, director of Public Citizen's Congress Watch division, said in a statement that the numbers indicate that many victims of medical malpractice receive no compensation for their injuries.

Environmental-Health Tool Launched

The Centers for Disease Control and Prevention has launched an online tool so health professionals, scientists, and—for the first time—the public can track environmental exposures to pollutants and chronic health conditions together. The Environmental Public Health Tracking Network combines nationwide data on air and water pollution and conditions such as asthma, cancer, childhood lead poisoning, and heart disease. The CDC said the network should reveal links between environmental and health conditions. The tracking tool is located at

www.cdc.gov/ephtracking

FTC Wants 'Pay-for-Delay' Outlawed

A new law to eliminate deals in which pharmaceutical companies agree with their competitors to keep low-cost generic drugs off the market could save consumers and the federal government $3.5 billion a year over the next decade, according to Federal Trade Commission Chairman Jon Leibowitz. In a speech, Mr. Leibowitz said that stopping these “pay-for-delay” deals is one of the FTC's top priorities, although a series of recent court rulings has allowed some of the arrangements to continue. For instance, the U.S. Supreme Court recently declined to hear a case brought by consumers and health plans challenging a $398 million payment by drug maker Bayer AG to Barr Laboratories Inc. to settle the companies' patent dispute over a generic version of the antibiotic Cipro (ciprofloxacin).

Many Young Adults Uninsured

Approximately 5 million U.S. adults aged 19-23 years had no health insurance in 2006 for the entire year, and 30% said they didn't think it was worth the cost, according to the Agency for Healthcare Research and Quality. The AHRQ found that 46% of uninsured young adults worked full-time and 26% worked part-time. Only 19% of those uninsured throughout 2006 were full-time students, the agency said. In addition, 19- to 23-year-olds who were uninsured for the entire year were only about half as likely as those who had insurance part of the year to have a usual source of care, such as a family doctor—just 36% of the wholly uninsured reported a usual source of care. In fact, about two-thirds of the young adults who went without insurance for the whole year never saw a doctor at all, the AHRQ found.

egmnblog.wordpress.com

Hospitals OK Cuts for Reform

Three major hospital organizations, including the American Hospital Association, have agreed to accept $155 billion in reimbursement cuts for hospitals over the next 10 years as part of health care reform legislation. In a deal negotiated by key Senate lawmakers and announced by Vice President Joe Biden, hospitals would see reductions in their Medicare and Medicaid fees, in addition to $50 billion in cuts in the programs that help pay for care to the uninsured. Some of the cuts would take effect only if reform reduces the uninsured population. The AHA suggested that the deal was as far as hospitals could go: Reimbursement couldn't be cut further “without damaging hospitals' ability to care for their communities.” And two groups that didn't take part in the negotiations, representing public hospitals and children's hospitals, warned that cuts—if not carefully crafted—could hurt institutions caring for large numbers of Medicaid patients.

FDA Seeks Tobacco Comments

The Food and Drug Administration wants public input on how to implement its new authority to regulate tobacco products. In a Federal Register notice, the FDA said it will rely on the public comments when implementing the new Family Smoking Prevention and Tobacco Control Act and when establishing the FDA Center for Tobacco Products. The agency said it's particularly interested in suggestions for reducing tobacco use and protecting public health, but that remarks on any aspect of its new regulatory authority are welcome. Comments will be accepted until Sept. 29, and all will be posted online. They may be submitted at

www.regulations.gov

Malpractice Payments Are Down

Medical malpractice payments were at record low levels in 2008, according to an analysis by the consumer-advocacy group Public Citizen. For the third straight year, 2008 saw the lowest number of malpractice payments since the federal government's National Practitioner Data Bank began tracking such data in 1990, the group said. The data showed that 11,037 payments were made last year, which Public Citizen said was nearly one-third lower than the historical average. The monetary value of payments was either the lowest or second-lowest since 1990, depending on how inflation was calculated, the group said. The total cost of all malpractice insurance premiums fell to much less than 1% of the total $2.1 trillion in annual health costs in 2006 (the most recent year for which full data were available). The cost of actual malpractice payments to patients fell to 0.2% of overall health costs, the group said. David Arkush, director of Public Citizen's Congress Watch division, said in a statement that the numbers indicate that many victims of medical malpractice receive no compensation for their injuries.

Environmental-Health Tool Launched

The Centers for Disease Control and Prevention has launched an online tool so health professionals, scientists, and—for the first time—the public can track environmental exposures to pollutants and chronic health conditions together. The Environmental Public Health Tracking Network combines nationwide data on air and water pollution and conditions such as asthma, cancer, childhood lead poisoning, and heart disease. The CDC said the network should reveal links between environmental and health conditions. The tracking tool is located at

www.cdc.gov/ephtracking

FTC Wants 'Pay-for-Delay' Outlawed

A new law to eliminate deals in which pharmaceutical companies agree with their competitors to keep low-cost generic drugs off the market could save consumers and the federal government $3.5 billion a year over the next decade, according to Federal Trade Commission Chairman Jon Leibowitz. In a speech, Mr. Leibowitz said that stopping these “pay-for-delay” deals is one of the FTC's top priorities, although a series of recent court rulings has allowed some of the arrangements to continue. For instance, the U.S. Supreme Court recently declined to hear a case brought by consumers and health plans challenging a $398 million payment by drug maker Bayer AG to Barr Laboratories Inc. to settle the companies' patent dispute over a generic version of the antibiotic Cipro (ciprofloxacin).

Many Young Adults Uninsured

Approximately 5 million U.S. adults aged 19-23 years had no health insurance in 2006 for the entire year, and 30% said they didn't think it was worth the cost, according to the Agency for Healthcare Research and Quality. The AHRQ found that 46% of uninsured young adults worked full-time and 26% worked part-time. Only 19% of those uninsured throughout 2006 were full-time students, the agency said. In addition, 19- to 23-year-olds who were uninsured for the entire year were only about half as likely as those who had insurance part of the year to have a usual source of care, such as a family doctor—just 36% of the wholly uninsured reported a usual source of care. In fact, about two-thirds of the young adults who went without insurance for the whole year never saw a doctor at all, the AHRQ found.

egmnblog.wordpress.com

Hospitals OK Cuts for Reform

Three major hospital organizations, including the American Hospital Association, have agreed to accept $155 billion in reimbursement cuts for hospitals over the next 10 years as part of health care reform legislation. In a deal negotiated by key Senate lawmakers and announced by Vice President Joe Biden, hospitals would see reductions in their Medicare and Medicaid fees, in addition to $50 billion in cuts in the programs that help pay for care to the uninsured. Some of the cuts would take effect only if reform reduces the uninsured population. The AHA suggested that the deal was as far as hospitals could go: Reimbursement couldn't be cut further “without damaging hospitals' ability to care for their communities.” And two groups that didn't take part in the negotiations, representing public hospitals and children's hospitals, warned that cuts—if not carefully crafted—could hurt institutions caring for large numbers of Medicaid patients.

FDA Seeks Tobacco Comments

The Food and Drug Administration wants public input on how to implement its new authority to regulate tobacco products. In a Federal Register notice, the FDA said it will rely on the public comments when implementing the new Family Smoking Prevention and Tobacco Control Act and when establishing the FDA Center for Tobacco Products. The agency said it's particularly interested in suggestions for reducing tobacco use and protecting public health, but that remarks on any aspect of its new regulatory authority are welcome. Comments will be accepted until Sept. 29, and all will be posted online. They may be submitted at

www.regulations.gov

Malpractice Payments Are Down

Medical malpractice payments were at record low levels in 2008, according to an analysis by the consumer-advocacy group Public Citizen. For the third straight year, 2008 saw the lowest number of malpractice payments since the federal government's National Practitioner Data Bank began tracking such data in 1990, the group said. The data showed that 11,037 payments were made last year, which Public Citizen said was nearly one-third lower than the historical average. The monetary value of payments was either the lowest or second-lowest since 1990, depending on how inflation was calculated, the group said. The total cost of all malpractice insurance premiums fell to much less than 1% of the total $2.1 trillion in annual health costs in 2006 (the most recent year for which full data were available). The cost of actual malpractice payments to patients fell to 0.2% of overall health costs, the group said. David Arkush, director of Public Citizen's Congress Watch division, said in a statement that the numbers indicate that many victims of medical malpractice receive no compensation for their injuries.

Environmental-Health Tool Launched

The Centers for Disease Control and Prevention has launched an online tool so health professionals, scientists, and—for the first time—the public can track environmental exposures to pollutants and chronic health conditions together. The Environmental Public Health Tracking Network combines nationwide data on air and water pollution and conditions such as asthma, cancer, childhood lead poisoning, and heart disease. The CDC said the network should reveal links between environmental and health conditions. The tracking tool is located at

www.cdc.gov/ephtracking

FTC Wants 'Pay-for-Delay' Outlawed

A new law to eliminate deals in which pharmaceutical companies agree with their competitors to keep low-cost generic drugs off the market could save consumers and the federal government $3.5 billion a year over the next decade, according to Federal Trade Commission Chairman Jon Leibowitz. In a speech, Mr. Leibowitz said that stopping these “pay-for-delay” deals is one of the FTC's top priorities, although a series of recent court rulings has allowed some of the arrangements to continue. For instance, the U.S. Supreme Court recently declined to hear a case brought by consumers and health plans challenging a $398 million payment by drug maker Bayer AG to Barr Laboratories Inc. to settle the companies' patent dispute over a generic version of the antibiotic Cipro (ciprofloxacin).

Many Young Adults Uninsured

Approximately 5 million U.S. adults aged 19-23 years had no health insurance in 2006 for the entire year, and 30% said they didn't think it was worth the cost, according to the Agency for Healthcare Research and Quality. The AHRQ found that 46% of uninsured young adults worked full-time and 26% worked part-time. Only 19% of those uninsured throughout 2006 were full-time students, the agency said. In addition, 19- to 23-year-olds who were uninsured for the entire year were only about half as likely as those who had insurance part of the year to have a usual source of care, such as a family doctor—just 36% of the wholly uninsured reported a usual source of care. In fact, about two-thirds of the young adults who went without insurance for the whole year never saw a doctor at all, the AHRQ found.

Demand for many medical specialists remains strong, and group practices and hospitals are focused on recruiting psychiatrists, family physicians, general internists, hospitalists, and pediatricians. However, primary care physicians are in greater demand than any other kind of doctor, a review of physician recruitment shows.

In “2009 Review of Physician Recruiting Incentives,” the physician-recruiting firm Merritt Hawkins & Associates notes that in the past year it handled more requests for family physicians than for any other specialty type.

Requests for primary care physicians between April 2008 and March 2009 increased 23% over the previous year, the Irving, Tex.-based company said.

It added that although insurers and government programs are increasing their focus on primary care, fewer physicians in training are choosing to be generalists.

A spokeswoman for the Medical Group Management Association agreed that primary care physicians are in higher demand than other specialties. She added, however, that MGMA's own surveys show that increases in primary care physicians' incomes overall have not been beating inflation.

On the other hand, the review by Merritt Hawkins, which tracks more than 3,200 physician recruiting assignments, found that salaries offered to newly recruited physicians reflect the increased demand.

According to the company, the average salary or income guarantee offered to family physicians jumped 19 percent in the past 3 years, to $173,000; the average offered to general internists rose 15 percent, to $186,000; and the average for pediatricians increased 13 percent, to $171,000.

David Nyman, manager of physician recruitment at the Marshfield Clinic in Wisconsin, said in an interview that the disparities between salary figures in the MGMA and Merritt Hawkins reports can be explained by the different groups of physicians involved.

Merritt Hawkins tends to take on the “harder” recruitment assignments and therefore can wind up paying physicians more than the average, he said.

Mr. Nyman added that he's seen an increase in the number of groups willing to help new physicians with their student loans as an incentive to sign on. Groups are well aware that few physicians are going into primary care these days, which is driving increased recruitment of generalists, Nyman said.

“People are adding primary physicians now, anticipating that it's going to be more difficult to find them down the road,” he said.

Mark Smith, president of Merritt Hawkins, echoed Mr. Nyman's sentiment about the enormous demand for primary care physicians.

“Virtually every hospital or large medical group in the United States would be happy to add a family physician or general internist,” Mr. Smith said in a statement. “There simply are not enough primary care doctors to go around.”

Demand is also robust for hospitalists, the report said, and that may be hurting primary care. Because many internists are choosing to practice as hospitalists, the supply of physicians for general internal medicine has been constrained, the report concluded.

Meanwhile, demand is strong for various specialists, particularly general surgeons, the Merritt Hawkins report found. General surgeons are becoming increasingly hard to recruit because fewer medical school graduates who choose surgery are opting for the full range of that specialty, the report said.

More than 40 percent of general surgeons are 55 or older, and many are retiring, the report said. Merritt Hawkins said it conducted nearly twice as many general surgery searches for clients in 2008-2009 as it did the previous year.

Psychiatry faces a similar situation, the report said, with demand for psychiatrists strong and many practicing psychiatrists near retirement.

Other specialty areas experiencing robust demand include orthopedic surgery, obstetrics/gynecology, cardiology, urology, pulmonology, gastroenterology, otolaryngology, hematology/oncology, dermatology, neurology, and emergency medicine.

The search firm reported that 85% of all physicians were offered signing bonuses in 2008-2009, compared with just 58% 3 years ago. The average signing bonus offered to all physicians last year was $24,850. The report also suggested that more hospitals are hiring physicians as employees and paying them salaries. In 2005-2006, 23% of the physician-search assignments Merritt Hawkins handled involved physician employment by a hospital. In 2008-2009, that number increased to 45% percent.

“Many physicians today are simply throwing in the towel when it comes to private practice,” Mr. Smith of Merritt Hawkins said in the statement. “They are exchanging independence for the relative simplicity and security of employment.”

Demand for many medical specialists remains strong, and group practices and hospitals are focused on recruiting psychiatrists, family physicians, general internists, hospitalists, and pediatricians. However, primary care physicians are in greater demand than any other kind of doctor, a review of physician recruitment shows.

In “2009 Review of Physician Recruiting Incentives,” the physician-recruiting firm Merritt Hawkins & Associates notes that in the past year it handled more requests for family physicians than for any other specialty type.

Requests for primary care physicians between April 2008 and March 2009 increased 23% over the previous year, the Irving, Tex.-based company said.

It added that although insurers and government programs are increasing their focus on primary care, fewer physicians in training are choosing to be generalists.

A spokeswoman for the Medical Group Management Association agreed that primary care physicians are in higher demand than other specialties. She added, however, that MGMA's own surveys show that increases in primary care physicians' incomes overall have not been beating inflation.

On the other hand, the review by Merritt Hawkins, which tracks more than 3,200 physician recruiting assignments, found that salaries offered to newly recruited physicians reflect the increased demand.

According to the company, the average salary or income guarantee offered to family physicians jumped 19 percent in the past 3 years, to $173,000; the average offered to general internists rose 15 percent, to $186,000; and the average for pediatricians increased 13 percent, to $171,000.

David Nyman, manager of physician recruitment at the Marshfield Clinic in Wisconsin, said in an interview that the disparities between salary figures in the MGMA and Merritt Hawkins reports can be explained by the different groups of physicians involved.

Merritt Hawkins tends to take on the “harder” recruitment assignments and therefore can wind up paying physicians more than the average, he said.

Mr. Nyman added that he's seen an increase in the number of groups willing to help new physicians with their student loans as an incentive to sign on. Groups are well aware that few physicians are going into primary care these days, which is driving increased recruitment of generalists, Nyman said.

“People are adding primary physicians now, anticipating that it's going to be more difficult to find them down the road,” he said.

Mark Smith, president of Merritt Hawkins, echoed Mr. Nyman's sentiment about the enormous demand for primary care physicians.

“Virtually every hospital or large medical group in the United States would be happy to add a family physician or general internist,” Mr. Smith said in a statement. “There simply are not enough primary care doctors to go around.”

Demand is also robust for hospitalists, the report said, and that may be hurting primary care. Because many internists are choosing to practice as hospitalists, the supply of physicians for general internal medicine has been constrained, the report concluded.

Meanwhile, demand is strong for various specialists, particularly general surgeons, the Merritt Hawkins report found. General surgeons are becoming increasingly hard to recruit because fewer medical school graduates who choose surgery are opting for the full range of that specialty, the report said.

More than 40 percent of general surgeons are 55 or older, and many are retiring, the report said. Merritt Hawkins said it conducted nearly twice as many general surgery searches for clients in 2008-2009 as it did the previous year.

Psychiatry faces a similar situation, the report said, with demand for psychiatrists strong and many practicing psychiatrists near retirement.

Other specialty areas experiencing robust demand include orthopedic surgery, obstetrics/gynecology, cardiology, urology, pulmonology, gastroenterology, otolaryngology, hematology/oncology, dermatology, neurology, and emergency medicine.

The search firm reported that 85% of all physicians were offered signing bonuses in 2008-2009, compared with just 58% 3 years ago. The average signing bonus offered to all physicians last year was $24,850. The report also suggested that more hospitals are hiring physicians as employees and paying them salaries. In 2005-2006, 23% of the physician-search assignments Merritt Hawkins handled involved physician employment by a hospital. In 2008-2009, that number increased to 45% percent.

“Many physicians today are simply throwing in the towel when it comes to private practice,” Mr. Smith of Merritt Hawkins said in the statement. “They are exchanging independence for the relative simplicity and security of employment.”

Demand for many medical specialists remains strong, and group practices and hospitals are focused on recruiting psychiatrists, family physicians, general internists, hospitalists, and pediatricians. However, primary care physicians are in greater demand than any other kind of doctor, a review of physician recruitment shows.

In “2009 Review of Physician Recruiting Incentives,” the physician-recruiting firm Merritt Hawkins & Associates notes that in the past year it handled more requests for family physicians than for any other specialty type.

Requests for primary care physicians between April 2008 and March 2009 increased 23% over the previous year, the Irving, Tex.-based company said.

It added that although insurers and government programs are increasing their focus on primary care, fewer physicians in training are choosing to be generalists.

A spokeswoman for the Medical Group Management Association agreed that primary care physicians are in higher demand than other specialties. She added, however, that MGMA's own surveys show that increases in primary care physicians' incomes overall have not been beating inflation.

On the other hand, the review by Merritt Hawkins, which tracks more than 3,200 physician recruiting assignments, found that salaries offered to newly recruited physicians reflect the increased demand.

According to the company, the average salary or income guarantee offered to family physicians jumped 19 percent in the past 3 years, to $173,000; the average offered to general internists rose 15 percent, to $186,000; and the average for pediatricians increased 13 percent, to $171,000.

David Nyman, manager of physician recruitment at the Marshfield Clinic in Wisconsin, said in an interview that the disparities between salary figures in the MGMA and Merritt Hawkins reports can be explained by the different groups of physicians involved.

Merritt Hawkins tends to take on the “harder” recruitment assignments and therefore can wind up paying physicians more than the average, he said.

Mr. Nyman added that he's seen an increase in the number of groups willing to help new physicians with their student loans as an incentive to sign on. Groups are well aware that few physicians are going into primary care these days, which is driving increased recruitment of generalists, Nyman said.

“People are adding primary physicians now, anticipating that it's going to be more difficult to find them down the road,” he said.

Mark Smith, president of Merritt Hawkins, echoed Mr. Nyman's sentiment about the enormous demand for primary care physicians.

“Virtually every hospital or large medical group in the United States would be happy to add a family physician or general internist,” Mr. Smith said in a statement. “There simply are not enough primary care doctors to go around.”

Demand is also robust for hospitalists, the report said, and that may be hurting primary care. Because many internists are choosing to practice as hospitalists, the supply of physicians for general internal medicine has been constrained, the report concluded.

Meanwhile, demand is strong for various specialists, particularly general surgeons, the Merritt Hawkins report found. General surgeons are becoming increasingly hard to recruit because fewer medical school graduates who choose surgery are opting for the full range of that specialty, the report said.

More than 40 percent of general surgeons are 55 or older, and many are retiring, the report said. Merritt Hawkins said it conducted nearly twice as many general surgery searches for clients in 2008-2009 as it did the previous year.

Psychiatry faces a similar situation, the report said, with demand for psychiatrists strong and many practicing psychiatrists near retirement.

Other specialty areas experiencing robust demand include orthopedic surgery, obstetrics/gynecology, cardiology, urology, pulmonology, gastroenterology, otolaryngology, hematology/oncology, dermatology, neurology, and emergency medicine.

The search firm reported that 85% of all physicians were offered signing bonuses in 2008-2009, compared with just 58% 3 years ago. The average signing bonus offered to all physicians last year was $24,850. The report also suggested that more hospitals are hiring physicians as employees and paying them salaries. In 2005-2006, 23% of the physician-search assignments Merritt Hawkins handled involved physician employment by a hospital. In 2008-2009, that number increased to 45% percent.

“Many physicians today are simply throwing in the towel when it comes to private practice,” Mr. Smith of Merritt Hawkins said in the statement. “They are exchanging independence for the relative simplicity and security of employment.”

Although demand for many medical specialists remains strong, group practices and hospitals are focused on recruiting general internists, hospitalists, family physicians, pediatricians, and psychiatrists, according to a review of physician recruitment.

In “2009 Review of Physician Recruiting Incentives,” the physician-search firm Merritt Hawkins & Associates notes that in the past year it handled more requests for family physicians than for any other specialty type. Requests for primary care physicians between April 2008 and March 2009 increased 23% over the previous year, the company said. It added that although insurers and government programs are increasing their focus on primary care, fewer physicians in training are choosing to be generalists.

A spokeswoman for the Medical Group Management Association agreed that primary care physicians are in higher demand than other specialties. She added, however, that MGMA's own surveys show that increases in primary care physicians' incomes overall haven't been beating inflation.

On the other hand, the review by Merritt Hawkins, which tracks over 3,200 physician recruiting assignments, found that salaries offered to newly recruited physicians reflect the increased demand. According to the company, the average salary or income guarantee offered to family physicians jumped 19% in the past 3 years, to $173,000; the average offered to general internists rose 15%, to $186,000; and the average for pediatricians increased 13%, to $171,000.

David Nyman, manager of physician recruitment at the Marshfield Clinic in Wisconsin, said in an interview that the disparities between salary figures in the MGMA and Merritt Hawkins reports can be explained by the different groups of physicians involved. Merritt Hawkins tends to take on the “harder” recruitment assignments and therefore can wind up paying physicians more than the average, he said.

Mr. Nyman added that he's seen an increase in the number of groups willing to help new physicians with their student loans as an incentive to sign on. Groups are well aware that few physicians are going into primary care these days, which is driving increased recruitment of generalists, he said. “People are adding primary physicians now, anticipating that it's going to be more difficult to find them down the road,” he said.

“Virtually every hospital or large medical group in the United States would be happy to add a family physician or general internist,” said Merritt Hawkins' president, Mark Smith, in a statement. “There simply are not enough primary care doctors to go around.”

Demand is also robust for hospitalists, the report said, and that may be hurting primary care. Because many internists are choosing to practice as hospitalists, the supply of physicians for general internal medicine has been constrained, the report concluded.

Meanwhile, demand is strong for various specialists, particularly general surgeons, the Merritt Hawkins report found. More than 40% of general surgeons are 55 or older and many are retiring, the report said. Merritt Hawkins said it conducted nearly twice as many general surgery searches for clients in 2008-2009 as it did the previous year.

Psychiatry faces a similar situation, the report said, with demand for psychiatrists strong and many practicing psychiatrists near retirement. Other specialty areas experiencing robust demand include orthopedic surgery, obstetrics/gynecology, cardiology, urology, pulmonology, gastroenterology, otolaryngology, hematology/oncology, dermatology, neurology, and emergency medicine.

The search firm reported that 85% of all physicians were offered signing bonuses in 2008-2009, compared with just 58% 3 years ago. The average signing bonus last year was $24,850.

The report also suggested that more hospitals are hiring physicians as employees and paying them salaries. In 2005-2006, 23% of the physician-search assignments Merritt Hawkins handled involved physician employment by a hospital. In 2008-2009, that rate increased to 45%.

Although demand for many medical specialists remains strong, group practices and hospitals are focused on recruiting general internists, hospitalists, family physicians, pediatricians, and psychiatrists, according to a review of physician recruitment.

In “2009 Review of Physician Recruiting Incentives,” the physician-search firm Merritt Hawkins & Associates notes that in the past year it handled more requests for family physicians than for any other specialty type. Requests for primary care physicians between April 2008 and March 2009 increased 23% over the previous year, the company said. It added that although insurers and government programs are increasing their focus on primary care, fewer physicians in training are choosing to be generalists.

A spokeswoman for the Medical Group Management Association agreed that primary care physicians are in higher demand than other specialties. She added, however, that MGMA's own surveys show that increases in primary care physicians' incomes overall haven't been beating inflation.

On the other hand, the review by Merritt Hawkins, which tracks over 3,200 physician recruiting assignments, found that salaries offered to newly recruited physicians reflect the increased demand. According to the company, the average salary or income guarantee offered to family physicians jumped 19% in the past 3 years, to $173,000; the average offered to general internists rose 15%, to $186,000; and the average for pediatricians increased 13%, to $171,000.

David Nyman, manager of physician recruitment at the Marshfield Clinic in Wisconsin, said in an interview that the disparities between salary figures in the MGMA and Merritt Hawkins reports can be explained by the different groups of physicians involved. Merritt Hawkins tends to take on the “harder” recruitment assignments and therefore can wind up paying physicians more than the average, he said.

Mr. Nyman added that he's seen an increase in the number of groups willing to help new physicians with their student loans as an incentive to sign on. Groups are well aware that few physicians are going into primary care these days, which is driving increased recruitment of generalists, he said. “People are adding primary physicians now, anticipating that it's going to be more difficult to find them down the road,” he said.

“Virtually every hospital or large medical group in the United States would be happy to add a family physician or general internist,” said Merritt Hawkins' president, Mark Smith, in a statement. “There simply are not enough primary care doctors to go around.”

Demand is also robust for hospitalists, the report said, and that may be hurting primary care. Because many internists are choosing to practice as hospitalists, the supply of physicians for general internal medicine has been constrained, the report concluded.

Meanwhile, demand is strong for various specialists, particularly general surgeons, the Merritt Hawkins report found. More than 40% of general surgeons are 55 or older and many are retiring, the report said. Merritt Hawkins said it conducted nearly twice as many general surgery searches for clients in 2008-2009 as it did the previous year.

Psychiatry faces a similar situation, the report said, with demand for psychiatrists strong and many practicing psychiatrists near retirement. Other specialty areas experiencing robust demand include orthopedic surgery, obstetrics/gynecology, cardiology, urology, pulmonology, gastroenterology, otolaryngology, hematology/oncology, dermatology, neurology, and emergency medicine.

The search firm reported that 85% of all physicians were offered signing bonuses in 2008-2009, compared with just 58% 3 years ago. The average signing bonus last year was $24,850.

The report also suggested that more hospitals are hiring physicians as employees and paying them salaries. In 2005-2006, 23% of the physician-search assignments Merritt Hawkins handled involved physician employment by a hospital. In 2008-2009, that rate increased to 45%.

Although demand for many medical specialists remains strong, group practices and hospitals are focused on recruiting general internists, hospitalists, family physicians, pediatricians, and psychiatrists, according to a review of physician recruitment.

In “2009 Review of Physician Recruiting Incentives,” the physician-search firm Merritt Hawkins & Associates notes that in the past year it handled more requests for family physicians than for any other specialty type. Requests for primary care physicians between April 2008 and March 2009 increased 23% over the previous year, the company said. It added that although insurers and government programs are increasing their focus on primary care, fewer physicians in training are choosing to be generalists.

A spokeswoman for the Medical Group Management Association agreed that primary care physicians are in higher demand than other specialties. She added, however, that MGMA's own surveys show that increases in primary care physicians' incomes overall haven't been beating inflation.

On the other hand, the review by Merritt Hawkins, which tracks over 3,200 physician recruiting assignments, found that salaries offered to newly recruited physicians reflect the increased demand. According to the company, the average salary or income guarantee offered to family physicians jumped 19% in the past 3 years, to $173,000; the average offered to general internists rose 15%, to $186,000; and the average for pediatricians increased 13%, to $171,000.

David Nyman, manager of physician recruitment at the Marshfield Clinic in Wisconsin, said in an interview that the disparities between salary figures in the MGMA and Merritt Hawkins reports can be explained by the different groups of physicians involved. Merritt Hawkins tends to take on the “harder” recruitment assignments and therefore can wind up paying physicians more than the average, he said.

Mr. Nyman added that he's seen an increase in the number of groups willing to help new physicians with their student loans as an incentive to sign on. Groups are well aware that few physicians are going into primary care these days, which is driving increased recruitment of generalists, he said. “People are adding primary physicians now, anticipating that it's going to be more difficult to find them down the road,” he said.

“Virtually every hospital or large medical group in the United States would be happy to add a family physician or general internist,” said Merritt Hawkins' president, Mark Smith, in a statement. “There simply are not enough primary care doctors to go around.”

Demand is also robust for hospitalists, the report said, and that may be hurting primary care. Because many internists are choosing to practice as hospitalists, the supply of physicians for general internal medicine has been constrained, the report concluded.

Meanwhile, demand is strong for various specialists, particularly general surgeons, the Merritt Hawkins report found. More than 40% of general surgeons are 55 or older and many are retiring, the report said. Merritt Hawkins said it conducted nearly twice as many general surgery searches for clients in 2008-2009 as it did the previous year.

Psychiatry faces a similar situation, the report said, with demand for psychiatrists strong and many practicing psychiatrists near retirement. Other specialty areas experiencing robust demand include orthopedic surgery, obstetrics/gynecology, cardiology, urology, pulmonology, gastroenterology, otolaryngology, hematology/oncology, dermatology, neurology, and emergency medicine.

The search firm reported that 85% of all physicians were offered signing bonuses in 2008-2009, compared with just 58% 3 years ago. The average signing bonus last year was $24,850.

The report also suggested that more hospitals are hiring physicians as employees and paying them salaries. In 2005-2006, 23% of the physician-search assignments Merritt Hawkins handled involved physician employment by a hospital. In 2008-2009, that rate increased to 45%.

Hospitals OK Cuts for Reform

The American Hospital Association and two other hospital organizations have agreed to accept $155 billion in reimbursement cuts for hospitals over the next 10 years as part of health care reform. In a deal negotiated by Senate lawmakers and announced by Vice President Joe Biden, hospitals would see reductions in their Medicare and Medicaid fees, in addition to $50 billion in cuts in programs that help pay for care to the uninsured. Some of the cuts would take effect only if reform reduces the uninsured population. The AHA suggested that the deal was as far as hospitals could go: Reimbursement couldn't be cut further “without damaging hospitals' ability to care for their communities.” Two groups that did not take part in the negotiations, representing public hospitals and children's hospitals, warned that cuts, if not carefully crafted, could hurt institutions caring for large numbers of Medicaid patients.

FDA Seeks Tobacco Comments

The Food and Drug Administration wants public input on how to implement its new authority to regulate tobacco products. In a Federal Register notice, the FDA said it will rely on the public comments when implementing the new Family Smoking Prevention and Tobacco Control Act and when establishing the FDA Center for Tobacco Products. The agency said it's particularly interested in suggestions for reducing tobacco use and protecting public health, but that remarks on any aspect of its new regulatory authority are welcome. Comments will be accepted at

www.regulations.gov

Malpractice Payments Are Down

Medical malpractice payments reached record lows in 2008, according to an analysis by the consumer-advocacy group Public Citizen. For the third straight year, 2008 saw the lowest number of malpractice payments since the National Practitioner Data Bank began tracking such data in 1990, the group said. Last year, 11,037 payments were made, which Public Citizen said was nearly one-third lower than the historical average. The monetary value of payments was either the lowest or second-lowest since 1990, depending on how inflation was calculated, and the cost of malpractice payments to patients fell to 0.2% of overall health costs, the group said. The total cost of all malpractice insurance premiums fell to much less than 1% of the total $2.1 trillion in annual health costs in 2006 (the most recent year for which full data were available). David Arkush, director of Public Citizen's Congress Watch division, said in a statement that the data show that many victims of medical malpractice receive no compensation for their injuries.

Tool Tracks Environmental Health

The Centers for Disease Control and Prevention has launched an online tool so health professionals, scientists, and— for the first time—the public can track environmental exposures to pollutants and chronic health conditions together. The Environmental Public Health Tracking Network combines nationwide data on air and water pollution and conditions such as asthma, cancer, childhood lead poisoning, and heart disease. The CDC said the network should reveal links between environmental and health conditions. The tracking tool is located at

www.cdc.gov/ephtracking

FTC Wants to Stop 'Pay-for-Delay'

A new law to eliminate deals in which pharmaceutical companies work with their competitors to keep low-cost generic drugs off the market could save consumers and the federal government $3.5 billion a year over the next decade, according to Federal Trade Commission Chairman Jon Leibowitz. In a speech, Mr. Leibowitz said that stopping these “pay-for-delay” deals is one of the FTC's top priorities, although a series of recent court rulings has allowed some of the arrangements to continue. For instance, the U.S. Supreme Court recently declined to hear a case brought by consumers and health plans challenging a $398 million payment by drug maker Bayer AG to Barr Laboratories Inc. to settle the companies' patent dispute over a generic version of the antibiotic Cipro (ciprofloxacin). “The FTC is continuing to bring cases to protect consumers from these anticompetitive settlements … but waiting for a potential judicial solution is a time-consuming and expensive prescription, so the agency strongly supports legislation to eliminate pay-for-delay deals,” Mr. Leibowitz said.

Many Young Adults Uninsured

Approximately 5 million adults aged 19-23 years in the United States, or 24% of that age group, had no health insurance in 2006 for the entire year, and 30% of them said they didn't think it was worth the cost, according to the Agency for Healthcare Research and Quality. The AHRQ found that 46% of uninsured young adults worked full-time and 26% worked part-time. Only 19% of those who were uninsured throughout 2006 were full-time students, the agency said. In addition, 19- to 23-year-olds who were uninsured for the entire year were only about half as likely as those who had insurance part of the year to have a usual source of care, such as a family doctor—just 36% of the wholly uninsured reported a usual source of care. In fact, about two-thirds of the young adults who went without insurance for the whole year never saw a doctor at all, the AHRQ found.

Hospitals OK Cuts for Reform

The American Hospital Association and two other hospital organizations have agreed to accept $155 billion in reimbursement cuts for hospitals over the next 10 years as part of health care reform. In a deal negotiated by Senate lawmakers and announced by Vice President Joe Biden, hospitals would see reductions in their Medicare and Medicaid fees, in addition to $50 billion in cuts in programs that help pay for care to the uninsured. Some of the cuts would take effect only if reform reduces the uninsured population. The AHA suggested that the deal was as far as hospitals could go: Reimbursement couldn't be cut further “without damaging hospitals' ability to care for their communities.” Two groups that did not take part in the negotiations, representing public hospitals and children's hospitals, warned that cuts, if not carefully crafted, could hurt institutions caring for large numbers of Medicaid patients.

FDA Seeks Tobacco Comments

The Food and Drug Administration wants public input on how to implement its new authority to regulate tobacco products. In a Federal Register notice, the FDA said it will rely on the public comments when implementing the new Family Smoking Prevention and Tobacco Control Act and when establishing the FDA Center for Tobacco Products. The agency said it's particularly interested in suggestions for reducing tobacco use and protecting public health, but that remarks on any aspect of its new regulatory authority are welcome. Comments will be accepted at

www.regulations.gov

Malpractice Payments Are Down

Medical malpractice payments reached record lows in 2008, according to an analysis by the consumer-advocacy group Public Citizen. For the third straight year, 2008 saw the lowest number of malpractice payments since the National Practitioner Data Bank began tracking such data in 1990, the group said. Last year, 11,037 payments were made, which Public Citizen said was nearly one-third lower than the historical average. The monetary value of payments was either the lowest or second-lowest since 1990, depending on how inflation was calculated, and the cost of malpractice payments to patients fell to 0.2% of overall health costs, the group said. The total cost of all malpractice insurance premiums fell to much less than 1% of the total $2.1 trillion in annual health costs in 2006 (the most recent year for which full data were available). David Arkush, director of Public Citizen's Congress Watch division, said in a statement that the data show that many victims of medical malpractice receive no compensation for their injuries.

Tool Tracks Environmental Health

The Centers for Disease Control and Prevention has launched an online tool so health professionals, scientists, and— for the first time—the public can track environmental exposures to pollutants and chronic health conditions together. The Environmental Public Health Tracking Network combines nationwide data on air and water pollution and conditions such as asthma, cancer, childhood lead poisoning, and heart disease. The CDC said the network should reveal links between environmental and health conditions. The tracking tool is located at

www.cdc.gov/ephtracking

FTC Wants to Stop 'Pay-for-Delay'

A new law to eliminate deals in which pharmaceutical companies work with their competitors to keep low-cost generic drugs off the market could save consumers and the federal government $3.5 billion a year over the next decade, according to Federal Trade Commission Chairman Jon Leibowitz. In a speech, Mr. Leibowitz said that stopping these “pay-for-delay” deals is one of the FTC's top priorities, although a series of recent court rulings has allowed some of the arrangements to continue. For instance, the U.S. Supreme Court recently declined to hear a case brought by consumers and health plans challenging a $398 million payment by drug maker Bayer AG to Barr Laboratories Inc. to settle the companies' patent dispute over a generic version of the antibiotic Cipro (ciprofloxacin). “The FTC is continuing to bring cases to protect consumers from these anticompetitive settlements … but waiting for a potential judicial solution is a time-consuming and expensive prescription, so the agency strongly supports legislation to eliminate pay-for-delay deals,” Mr. Leibowitz said.

Many Young Adults Uninsured

Approximately 5 million adults aged 19-23 years in the United States, or 24% of that age group, had no health insurance in 2006 for the entire year, and 30% of them said they didn't think it was worth the cost, according to the Agency for Healthcare Research and Quality. The AHRQ found that 46% of uninsured young adults worked full-time and 26% worked part-time. Only 19% of those who were uninsured throughout 2006 were full-time students, the agency said. In addition, 19- to 23-year-olds who were uninsured for the entire year were only about half as likely as those who had insurance part of the year to have a usual source of care, such as a family doctor—just 36% of the wholly uninsured reported a usual source of care. In fact, about two-thirds of the young adults who went without insurance for the whole year never saw a doctor at all, the AHRQ found.

Hospitals OK Cuts for Reform

The American Hospital Association and two other hospital organizations have agreed to accept $155 billion in reimbursement cuts for hospitals over the next 10 years as part of health care reform. In a deal negotiated by Senate lawmakers and announced by Vice President Joe Biden, hospitals would see reductions in their Medicare and Medicaid fees, in addition to $50 billion in cuts in programs that help pay for care to the uninsured. Some of the cuts would take effect only if reform reduces the uninsured population. The AHA suggested that the deal was as far as hospitals could go: Reimbursement couldn't be cut further “without damaging hospitals' ability to care for their communities.” Two groups that did not take part in the negotiations, representing public hospitals and children's hospitals, warned that cuts, if not carefully crafted, could hurt institutions caring for large numbers of Medicaid patients.

FDA Seeks Tobacco Comments

The Food and Drug Administration wants public input on how to implement its new authority to regulate tobacco products. In a Federal Register notice, the FDA said it will rely on the public comments when implementing the new Family Smoking Prevention and Tobacco Control Act and when establishing the FDA Center for Tobacco Products. The agency said it's particularly interested in suggestions for reducing tobacco use and protecting public health, but that remarks on any aspect of its new regulatory authority are welcome. Comments will be accepted at

www.regulations.gov

Malpractice Payments Are Down

Medical malpractice payments reached record lows in 2008, according to an analysis by the consumer-advocacy group Public Citizen. For the third straight year, 2008 saw the lowest number of malpractice payments since the National Practitioner Data Bank began tracking such data in 1990, the group said. Last year, 11,037 payments were made, which Public Citizen said was nearly one-third lower than the historical average. The monetary value of payments was either the lowest or second-lowest since 1990, depending on how inflation was calculated, and the cost of malpractice payments to patients fell to 0.2% of overall health costs, the group said. The total cost of all malpractice insurance premiums fell to much less than 1% of the total $2.1 trillion in annual health costs in 2006 (the most recent year for which full data were available). David Arkush, director of Public Citizen's Congress Watch division, said in a statement that the data show that many victims of medical malpractice receive no compensation for their injuries.

Tool Tracks Environmental Health

The Centers for Disease Control and Prevention has launched an online tool so health professionals, scientists, and— for the first time—the public can track environmental exposures to pollutants and chronic health conditions together. The Environmental Public Health Tracking Network combines nationwide data on air and water pollution and conditions such as asthma, cancer, childhood lead poisoning, and heart disease. The CDC said the network should reveal links between environmental and health conditions. The tracking tool is located at

www.cdc.gov/ephtracking

FTC Wants to Stop 'Pay-for-Delay'

A new law to eliminate deals in which pharmaceutical companies work with their competitors to keep low-cost generic drugs off the market could save consumers and the federal government $3.5 billion a year over the next decade, according to Federal Trade Commission Chairman Jon Leibowitz. In a speech, Mr. Leibowitz said that stopping these “pay-for-delay” deals is one of the FTC's top priorities, although a series of recent court rulings has allowed some of the arrangements to continue. For instance, the U.S. Supreme Court recently declined to hear a case brought by consumers and health plans challenging a $398 million payment by drug maker Bayer AG to Barr Laboratories Inc. to settle the companies' patent dispute over a generic version of the antibiotic Cipro (ciprofloxacin). “The FTC is continuing to bring cases to protect consumers from these anticompetitive settlements … but waiting for a potential judicial solution is a time-consuming and expensive prescription, so the agency strongly supports legislation to eliminate pay-for-delay deals,” Mr. Leibowitz said.

Many Young Adults Uninsured

Approximately 5 million adults aged 19-23 years in the United States, or 24% of that age group, had no health insurance in 2006 for the entire year, and 30% of them said they didn't think it was worth the cost, according to the Agency for Healthcare Research and Quality. The AHRQ found that 46% of uninsured young adults worked full-time and 26% worked part-time. Only 19% of those who were uninsured throughout 2006 were full-time students, the agency said. In addition, 19- to 23-year-olds who were uninsured for the entire year were only about half as likely as those who had insurance part of the year to have a usual source of care, such as a family doctor—just 36% of the wholly uninsured reported a usual source of care. In fact, about two-thirds of the young adults who went without insurance for the whole year never saw a doctor at all, the AHRQ found.

Parents Focus on Kids' Health

American parents rate their own health care needs as significantly less important than the health needs of their children and say the economic downturn has affected their own health more than that of their children, according to a survey from drugmaker Boehringer Ingelheim. More than half of over 2,000 parents surveyed (54%) said their children's health care was their top priority, far outranking housing (25%), food and groceries (11%), and their own health needs (6%). Fewer than half of those surveyed said they have health insurance that generally meets their needs and is reasonably affordable, given their current financial situation.

HHS Releases Funds for CHIP

A total of $6 billion in new federal funds will be available for states and U.S. territories in 2009 to provide health care through their Children's Health Insurance Programs, the Department of Health and Human Services announced. The new funds come from the CHIP reauthorization act signed into law earlier this year, and they will help states and territories expand enrollment in the program, HHS said. With the new funding, CHIP will cover 11 million children, including 4 million who were previously uninsured, HHS Secretary Kathleen Sebelius said in a statement. HHS already has released more than $1 billion of the funds to states and said it expects to allocate the rest by the end of September.

Senators Revive Defibrillator Bill

Ohio's senators, George Voinovich (R) and Sherrod Brown (D), have reintroduced legislation that would put automatic external defibrillators (AEDs) in U.S. elementary and secondary schools. The bill is named for Josh Miller, an Ohio high school student who died on a football field following cardiac arrest. The bill would provide up to 75% of the cost of an AED, plus training.

Bisphenol-A Is Focus Again

The Food and Drug Administration is conducting a new safety review of the chemical bisphenol-A in consumer products such as food containers. Rep. Henry Waxman (D-Calif.), chairman of the House Energy and Commerce Committee, recently requested that officials reevaluate the Bush administration's conclusion that the chemical is safe at current exposure levels. Rep. Waxman has called on the FDA to determine whether its interaction with industry groups during the review of bisphenol-A was appropriate.

New ADHD Society Debuts

The American Professional Society of ADHD and Related Disorders (APSARD) made its debut in June. The Mt. Royal, N.J.-based society claims to be the first devoted to ADHD and aims to improve quality of care, boost research, and disseminate best practices. The organization is also launching the quarterly peer-reviewed Journal of ADHD and Related Disorders. The board of directors includes Dr. Ronald Kessler of Harvard Medical School and Dr. Joseph Biederman, chief of the adult ADHD program at Massachusetts General Hospital. Dr. Biederman has been under fire from Sen. Chuck Grassley (R-Iowa) for alleged failures to disclose conflicts of interest. According to APSARD Executive Director Gene Terry, the society expects to fund the majority of its activities from journal subscriptions, advertising, and membership dues, and it will accept industry support for independent continuing medical education.

Parents Focus on Kids' Health

American parents rate their own health care needs as significantly less important than the health needs of their children and say the economic downturn has affected their own health more than that of their children, according to a survey from drugmaker Boehringer Ingelheim. More than half of over 2,000 parents surveyed (54%) said their children's health care was their top priority, far outranking housing (25%), food and groceries (11%), and their own health needs (6%). Fewer than half of those surveyed said they have health insurance that generally meets their needs and is reasonably affordable, given their current financial situation.

HHS Releases Funds for CHIP

A total of $6 billion in new federal funds will be available for states and U.S. territories in 2009 to provide health care through their Children's Health Insurance Programs, the Department of Health and Human Services announced. The new funds come from the CHIP reauthorization act signed into law earlier this year, and they will help states and territories expand enrollment in the program, HHS said. With the new funding, CHIP will cover 11 million children, including 4 million who were previously uninsured, HHS Secretary Kathleen Sebelius said in a statement. HHS already has released more than $1 billion of the funds to states and said it expects to allocate the rest by the end of September.

Senators Revive Defibrillator Bill

Ohio's senators, George Voinovich (R) and Sherrod Brown (D), have reintroduced legislation that would put automatic external defibrillators (AEDs) in U.S. elementary and secondary schools. The bill is named for Josh Miller, an Ohio high school student who died on a football field following cardiac arrest. The bill would provide up to 75% of the cost of an AED, plus training.

Bisphenol-A Is Focus Again

The Food and Drug Administration is conducting a new safety review of the chemical bisphenol-A in consumer products such as food containers. Rep. Henry Waxman (D-Calif.), chairman of the House Energy and Commerce Committee, recently requested that officials reevaluate the Bush administration's conclusion that the chemical is safe at current exposure levels. Rep. Waxman has called on the FDA to determine whether its interaction with industry groups during the review of bisphenol-A was appropriate.

New ADHD Society Debuts

The American Professional Society of ADHD and Related Disorders (APSARD) made its debut in June. The Mt. Royal, N.J.-based society claims to be the first devoted to ADHD and aims to improve quality of care, boost research, and disseminate best practices. The organization is also launching the quarterly peer-reviewed Journal of ADHD and Related Disorders. The board of directors includes Dr. Ronald Kessler of Harvard Medical School and Dr. Joseph Biederman, chief of the adult ADHD program at Massachusetts General Hospital. Dr. Biederman has been under fire from Sen. Chuck Grassley (R-Iowa) for alleged failures to disclose conflicts of interest. According to APSARD Executive Director Gene Terry, the society expects to fund the majority of its activities from journal subscriptions, advertising, and membership dues, and it will accept industry support for independent continuing medical education.

Parents Focus on Kids' Health

American parents rate their own health care needs as significantly less important than the health needs of their children and say the economic downturn has affected their own health more than that of their children, according to a survey from drugmaker Boehringer Ingelheim. More than half of over 2,000 parents surveyed (54%) said their children's health care was their top priority, far outranking housing (25%), food and groceries (11%), and their own health needs (6%). Fewer than half of those surveyed said they have health insurance that generally meets their needs and is reasonably affordable, given their current financial situation.

HHS Releases Funds for CHIP

A total of $6 billion in new federal funds will be available for states and U.S. territories in 2009 to provide health care through their Children's Health Insurance Programs, the Department of Health and Human Services announced. The new funds come from the CHIP reauthorization act signed into law earlier this year, and they will help states and territories expand enrollment in the program, HHS said. With the new funding, CHIP will cover 11 million children, including 4 million who were previously uninsured, HHS Secretary Kathleen Sebelius said in a statement. HHS already has released more than $1 billion of the funds to states and said it expects to allocate the rest by the end of September.

Senators Revive Defibrillator Bill

Ohio's senators, George Voinovich (R) and Sherrod Brown (D), have reintroduced legislation that would put automatic external defibrillators (AEDs) in U.S. elementary and secondary schools. The bill is named for Josh Miller, an Ohio high school student who died on a football field following cardiac arrest. The bill would provide up to 75% of the cost of an AED, plus training.

Bisphenol-A Is Focus Again

The Food and Drug Administration is conducting a new safety review of the chemical bisphenol-A in consumer products such as food containers. Rep. Henry Waxman (D-Calif.), chairman of the House Energy and Commerce Committee, recently requested that officials reevaluate the Bush administration's conclusion that the chemical is safe at current exposure levels. Rep. Waxman has called on the FDA to determine whether its interaction with industry groups during the review of bisphenol-A was appropriate.

New ADHD Society Debuts

The American Professional Society of ADHD and Related Disorders (APSARD) made its debut in June. The Mt. Royal, N.J.-based society claims to be the first devoted to ADHD and aims to improve quality of care, boost research, and disseminate best practices. The organization is also launching the quarterly peer-reviewed Journal of ADHD and Related Disorders. The board of directors includes Dr. Ronald Kessler of Harvard Medical School and Dr. Joseph Biederman, chief of the adult ADHD program at Massachusetts General Hospital. Dr. Biederman has been under fire from Sen. Chuck Grassley (R-Iowa) for alleged failures to disclose conflicts of interest. According to APSARD Executive Director Gene Terry, the society expects to fund the majority of its activities from journal subscriptions, advertising, and membership dues, and it will accept industry support for independent continuing medical education.

Vermont Bans Most Pharma Gifts

Vermont Gov. Jim Douglas (R) has signed into law a bill that prohibits manufacturers of drugs, medical devices, and biologics from providing free gifts, including meals and travel, to physicians and other health care providers. The toughest of its kind in the nation, the legislation also requires disclosure of any allowed gifts or payments, regardless of their value. Under the stronger law, manufacturers can give physicians only gifts such as samples intended for patients, “reasonable quantities” of medical device evaluation or demonstration units, and copies of peer-reviewed articles. They still can provide scholarships or other support for medical students, residents, and fellows to attend educational events held by professional associations.

More Flu Preparation Needed

Federal and state governments need to do more to prepare for possible pandemic flu, the Government Accountability Office (GAO) said after reviewing the H1N1 flu outbreak. The office acknowledged pandemic planning throughout government but said that more efforts are needed to improve disease surveillance and detection, address issues of coordination between various governmental entities, and improve capacity for patient care in the event of a pandemic. The GAO warned that the H1N1 virus could return next fall or winter in a more virulent form. Meanwhile, a Robert Wood Johnson Foundation report on the recent H1N1 outbreak concluded that health officials reacted effectively but urged improvements in the ability of providers to manage a massive influx of patients.

Minorities, Docs Miscommunicate

Black, Hispanic, and Asian patients are more likely than white patients to report problems communicating with their physicians, the Agency for Healthcare Research and Quality said. The AHRQ found that 13% of black and Asian patients, and 12% of Hispanic patients, said they had trouble communicating with their doctors in 2005, compared with 9% of whites. Roughly twice as many poor people as high-income people, regardless of their race or ethnicity, reported communication problems with their physician.

Bankruptcies, Illness Linked

Medical problems contributed to nearly two-thirds of all bankruptcies in the United States in 2007, according to a study in the American Journal of Medicine. Based on court-record reviews and interviews of more than 2,300 bankruptcy filers in 2007, the study found that 62% of filers cited medical debts and income lost to illness as reasons for seeking bankruptcy. Of these “medically bankrupt families,” 9 out of 10 said they had medical debts over $5,000, and the rest met criteria for medical bankruptcy because they had lost significant income because of illness or mortgaged a home to pay medical bills. Out-of-pocket medical costs averaged $17,943 for all medically bankrupt families, including the three-quarters of families that had insurance at the outset of their problems. Most medical debtors were well educated, owned homes, and had middle-class occupations, the study found.

Medical Homes, Clinics Urged

A series of innovations, including patient-centered medical homes and retail clinics staffed by nurse practitioners and physician assistants, would help transform the primary care system into one that is higher in quality and more effective, according to a report from the Massachusetts-based New England Healthcare Institute. The report noted that “the promise of a high-quality primary care system has remained largely unfulfilled” but said the current crisis in primary care offers an opportunity for change. In addition to urging adoption of the medical home model and retail clinics, the institute recommended such changes as shared medical appointments, open-access scheduling, more worksite wellness programs, and primary care home visits. The report said that improvements in health information technology could free physicians to spend more time with patients.

ED Overcrowding Continues

The emergency department wait time to see a physician for emergent patients—those who should be seen in 1-14 minutes—averaged 37 minutes in 2006. Half of such patients waited longer than recommended, the GAO said in a report. In addition, patients who should have been seen immediately waited an average of 28 minutes, and about three-fourths had to wait to be seen. Hospitals performed better with urgent cases: Those patients, who should be seen in 15-60 minutes, waited an average of 50 minutes, and only about 20% waited longer than recommended, the report said. Lack of inpatient beds continues to be the main driver of ED overcrowding. ED boarding of patients who are waiting for an inpatient bed continues to be a problem, the GAO noted. The American College of Emergency Physicians warned that overcrowding and wait times will only grow worse as the general population ages. “People age 65 and older represent the fastest growing segment of the population and the group whose visits to the emergency department are increasing the fastest,” Dr. Nicholas Jouriles, ACEP president, said in a statement.

Vermont Bans Most Pharma Gifts

Vermont Gov. Jim Douglas (R) has signed into law a bill that prohibits manufacturers of drugs, medical devices, and biologics from providing free gifts, including meals and travel, to physicians and other health care providers. The toughest of its kind in the nation, the legislation also requires disclosure of any allowed gifts or payments, regardless of their value. Under the stronger law, manufacturers can give physicians only gifts such as samples intended for patients, “reasonable quantities” of medical device evaluation or demonstration units, and copies of peer-reviewed articles. They still can provide scholarships or other support for medical students, residents, and fellows to attend educational events held by professional associations.

More Flu Preparation Needed

Federal and state governments need to do more to prepare for possible pandemic flu, the Government Accountability Office (GAO) said after reviewing the H1N1 flu outbreak. The office acknowledged pandemic planning throughout government but said that more efforts are needed to improve disease surveillance and detection, address issues of coordination between various governmental entities, and improve capacity for patient care in the event of a pandemic. The GAO warned that the H1N1 virus could return next fall or winter in a more virulent form. Meanwhile, a Robert Wood Johnson Foundation report on the recent H1N1 outbreak concluded that health officials reacted effectively but urged improvements in the ability of providers to manage a massive influx of patients.

Minorities, Docs Miscommunicate

Black, Hispanic, and Asian patients are more likely than white patients to report problems communicating with their physicians, the Agency for Healthcare Research and Quality said. The AHRQ found that 13% of black and Asian patients, and 12% of Hispanic patients, said they had trouble communicating with their doctors in 2005, compared with 9% of whites. Roughly twice as many poor people as high-income people, regardless of their race or ethnicity, reported communication problems with their physician.

Bankruptcies, Illness Linked

Medical problems contributed to nearly two-thirds of all bankruptcies in the United States in 2007, according to a study in the American Journal of Medicine. Based on court-record reviews and interviews of more than 2,300 bankruptcy filers in 2007, the study found that 62% of filers cited medical debts and income lost to illness as reasons for seeking bankruptcy. Of these “medically bankrupt families,” 9 out of 10 said they had medical debts over $5,000, and the rest met criteria for medical bankruptcy because they had lost significant income because of illness or mortgaged a home to pay medical bills. Out-of-pocket medical costs averaged $17,943 for all medically bankrupt families, including the three-quarters of families that had insurance at the outset of their problems. Most medical debtors were well educated, owned homes, and had middle-class occupations, the study found.

Medical Homes, Clinics Urged

A series of innovations, including patient-centered medical homes and retail clinics staffed by nurse practitioners and physician assistants, would help transform the primary care system into one that is higher in quality and more effective, according to a report from the Massachusetts-based New England Healthcare Institute. The report noted that “the promise of a high-quality primary care system has remained largely unfulfilled” but said the current crisis in primary care offers an opportunity for change. In addition to urging adoption of the medical home model and retail clinics, the institute recommended such changes as shared medical appointments, open-access scheduling, more worksite wellness programs, and primary care home visits. The report said that improvements in health information technology could free physicians to spend more time with patients.

ED Overcrowding Continues

The emergency department wait time to see a physician for emergent patients—those who should be seen in 1-14 minutes—averaged 37 minutes in 2006. Half of such patients waited longer than recommended, the GAO said in a report. In addition, patients who should have been seen immediately waited an average of 28 minutes, and about three-fourths had to wait to be seen. Hospitals performed better with urgent cases: Those patients, who should be seen in 15-60 minutes, waited an average of 50 minutes, and only about 20% waited longer than recommended, the report said. Lack of inpatient beds continues to be the main driver of ED overcrowding. ED boarding of patients who are waiting for an inpatient bed continues to be a problem, the GAO noted. The American College of Emergency Physicians warned that overcrowding and wait times will only grow worse as the general population ages. “People age 65 and older represent the fastest growing segment of the population and the group whose visits to the emergency department are increasing the fastest,” Dr. Nicholas Jouriles, ACEP president, said in a statement.

Vermont Bans Most Pharma Gifts

Vermont Gov. Jim Douglas (R) has signed into law a bill that prohibits manufacturers of drugs, medical devices, and biologics from providing free gifts, including meals and travel, to physicians and other health care providers. The toughest of its kind in the nation, the legislation also requires disclosure of any allowed gifts or payments, regardless of their value. Under the stronger law, manufacturers can give physicians only gifts such as samples intended for patients, “reasonable quantities” of medical device evaluation or demonstration units, and copies of peer-reviewed articles. They still can provide scholarships or other support for medical students, residents, and fellows to attend educational events held by professional associations.

More Flu Preparation Needed

Federal and state governments need to do more to prepare for possible pandemic flu, the Government Accountability Office (GAO) said after reviewing the H1N1 flu outbreak. The office acknowledged pandemic planning throughout government but said that more efforts are needed to improve disease surveillance and detection, address issues of coordination between various governmental entities, and improve capacity for patient care in the event of a pandemic. The GAO warned that the H1N1 virus could return next fall or winter in a more virulent form. Meanwhile, a Robert Wood Johnson Foundation report on the recent H1N1 outbreak concluded that health officials reacted effectively but urged improvements in the ability of providers to manage a massive influx of patients.

Minorities, Docs Miscommunicate

Black, Hispanic, and Asian patients are more likely than white patients to report problems communicating with their physicians, the Agency for Healthcare Research and Quality said. The AHRQ found that 13% of black and Asian patients, and 12% of Hispanic patients, said they had trouble communicating with their doctors in 2005, compared with 9% of whites. Roughly twice as many poor people as high-income people, regardless of their race or ethnicity, reported communication problems with their physician.

Bankruptcies, Illness Linked

Medical problems contributed to nearly two-thirds of all bankruptcies in the United States in 2007, according to a study in the American Journal of Medicine. Based on court-record reviews and interviews of more than 2,300 bankruptcy filers in 2007, the study found that 62% of filers cited medical debts and income lost to illness as reasons for seeking bankruptcy. Of these “medically bankrupt families,” 9 out of 10 said they had medical debts over $5,000, and the rest met criteria for medical bankruptcy because they had lost significant income because of illness or mortgaged a home to pay medical bills. Out-of-pocket medical costs averaged $17,943 for all medically bankrupt families, including the three-quarters of families that had insurance at the outset of their problems. Most medical debtors were well educated, owned homes, and had middle-class occupations, the study found.

Medical Homes, Clinics Urged

A series of innovations, including patient-centered medical homes and retail clinics staffed by nurse practitioners and physician assistants, would help transform the primary care system into one that is higher in quality and more effective, according to a report from the Massachusetts-based New England Healthcare Institute. The report noted that “the promise of a high-quality primary care system has remained largely unfulfilled” but said the current crisis in primary care offers an opportunity for change. In addition to urging adoption of the medical home model and retail clinics, the institute recommended such changes as shared medical appointments, open-access scheduling, more worksite wellness programs, and primary care home visits. The report said that improvements in health information technology could free physicians to spend more time with patients.

ED Overcrowding Continues

The emergency department wait time to see a physician for emergent patients—those who should be seen in 1-14 minutes—averaged 37 minutes in 2006. Half of such patients waited longer than recommended, the GAO said in a report. In addition, patients who should have been seen immediately waited an average of 28 minutes, and about three-fourths had to wait to be seen. Hospitals performed better with urgent cases: Those patients, who should be seen in 15-60 minutes, waited an average of 50 minutes, and only about 20% waited longer than recommended, the report said. Lack of inpatient beds continues to be the main driver of ED overcrowding. ED boarding of patients who are waiting for an inpatient bed continues to be a problem, the GAO noted. The American College of Emergency Physicians warned that overcrowding and wait times will only grow worse as the general population ages. “People age 65 and older represent the fastest growing segment of the population and the group whose visits to the emergency department are increasing the fastest,” Dr. Nicholas Jouriles, ACEP president, said in a statement.