May, 2007
Two New Public Policy Briefs
Two new AADE Public Policy Briefs were approved at the recent AADE Board
of Directors meeting. The PPBs - the “Diabetes Screening and Medicaid Savings
Act” (S.755) and the “GEstational DIabetes (GEDI) Act of 2007” (S. 907) are posted on the AADE website.
HHS Veteran Weems to Become Next
Administrator of CMS
President Bush intends to nominate
Department of Health and Human Services deputy chief of staff Kerry N. Weems, a
24-year veteran of the department, to be the next administrator of the Centers
for Medicare & Medicaid Services (CMS).
Small
Change Brings Big Improvement in Diabetes Care
A $400 annual investment
in diabetes care could save as much as $33,000 per patient per year over a
lifetime, according to investigators at the
Modest efforts to ensure that patients in
federally qualified community health centers are screened for diabetes and that
those who are diagnosed with the condition are followed to prevent
complications can reduce the lifetime incidence of diabetic retinopathy, renal
disease, and coronary artery disease.
Over five years, a federal
quality-improvement initiative, called the Health Disparities Collaborative,
produced significant improvements in a number of diabetes quality-of-care
parameters, including glycosylated hemoglobin (HbA1c) levels and preventive
cardiovascular care, the authors reported online in Health Services Research.
Physician
Groups Urge Congress to Adopt New Physician Payment System
Physician
groups have begun drafting a proposal for Congress to
overhaul Medicare's physician payment system by 2016 at the latest. Doctors
blame the current Medicare system for shortchanging physicians. Their advocacy
groups' proposal calls for immediately replacing the current system and its
sustainable growth rate (SGR) formula. If the system cannot be scrapped
immediately, the proposal calls for incorporating short-term payment increases
from 2008 through 2015, with a new payment system in place by 2016 eliminating
the SGR. The draft proposal, under development by the American Medical
Association and other physician groups, recommends that Congress permanently
replace the current physician payment system with a system that would base
annual payment updates on recommendations made by the Medicare Payment Advisory
Commission.
Lawmakers
have said addressing the scheduled payment cuts for doctors is a high priority
for Congress this year. Any payment fix
adopted by Congress, including cancelling the scheduled 2008 cut and replacing
it with a zero update, is expected to cost at a minimum in the tens of billions
of dollars.
GAO Recommends Efficiency Reports for Physicians in Medicare
Program
A Government Accountability Office (GAO)
report has recommended that the Centers for Medicare & Medicaid Services (CMS)
should develop a system that identifies physicians with inefficient practice
patterns, as a method of improving Medicare efficiency. (Focus on Physician Practice Patterns Can
Lead to Greater Program Efficiency (GAO-07-307))
CMS
officials have told Congress that adequate Medicare payment and other claims
information exists to move forward with a system of profiling individual
physicians' practice patterns, which supporters say could improve doctors'
efficiency and the quality of care. Medicare's data-rich environment is
conducive to identifying physicians who are likely to practice medicine
inefficiently. The Centers for Medicare
& Medicaid Services "has the tools to make statistically valid
comparisons, including comprehensive medical claims information, sufficient
numbers of physicians in most areas to construct adequate sample sizes, and
methods to adjust for differences in patient health status."
Blue Cross
Health Plans Recommend Institute to Study Treatments' Effectiveness
The Blue Cross and Blue Shield Association urged Congress
to establish an independent public/private institute to fund research on the
comparative effectiveness of various medical treatments, medications, and
medical devices, to be paid for by all health care payers, including Medicare,
Medicaid, and private insurers.
The institute would not conduct research, but rather would
fund such work, association officials said. Organizations already conducting
comparative effectiveness research, such as the federal Agency for Healthcare
Research and Quality, would continue to do so, with funding from the institute. The
institute would support research comparing the effectiveness of new and existing
medical procedures, prescription drugs, devices, and biologics and would focus
on funding clinical trials.
Despite Spending
More,
Despite spending more
money on health care, the
More information is
available at http://www.cmwf.org