The percentage of U.S. citizens screened for cancer remains below national targets, with significant disparities among racial and ethnic populations, according to the first federal study to identify cancer screening disparities among Asian and Hispanic groups.The report, Cancer Screening in the United States - 2010, was published by the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute (NCI) in the CDC Morbidity and Mortality Weekly Report. In 2010, breast cancer screening rates were 72.4 percent, below the Healthy People 2020 target of 81 percent; cervical cancer screening was 83 percent, below the target of 93 percent; and colorectal cancer screening was 58.6 percent, below the target of 70.5 percent, Screening rates for all three cancers were significantly lower among Asians (64.1 percent for breast cancer, 75.4 percent for cervical cancer, and 46.9 percent for colorectal cancer) compared to other groups, the study found. Hispanics were less likely to be screened for cervical and colorectal cancer (78.7 percent and 46.5 percent, respectively) when compared to non-Hispanics (83.8 percent and 59.9 percent, respectively). Healthy People 2020 sets national objectives for improving the health of all Americans. Such objectives include the use of screening tests recommended by the United States Preventive Services Task Force for breast, cervical and colorectal cancers. Women aged 50-74 years should be screened for breast cancer with a mammogram every two years. Women who have been sexually active for three years or are aged 21-65 years should be screened for cervical cancer with a Pap test at least every three years. Colorectal cancer screening is recommended for average-risk men and women aged 50-75 years, using high-sensitivity fecal occult blood test (FOBT), done at home every year; sigmoidoscopy every five years, with high-sensitivity FOBT every three years; or colonoscopy every 10 years. To assess the use of currently recommended cancer screening tests by age, race, ethnicity, education, length of residence in the United States, and the source and financing of health care researchers analyzed data from the 2010 National Health Interview Survey, which tracks progress toward the achievement of Healthy People 2020 objectives. For the ethnic subgroups, Asians were classified as Chinese, Filipino, or other Asian and Hispanics as Puerto Rican, Mexican, Mexican-American, Central or South American, or other Hispanic
CDC: Diabetes amputations falling dramaticallyby Mike StobbeFoot and leg amputations were once a fairly common fate for diabetics, but new government research shows a dramatic decline in limbs lost to the disease, probably due to better treatments. The rate has fallen by more than half since the mid-1990s, according to what is being called the most comprehensive study of the trend. Continue reading this story...
Adjust Advantage plan pay rates even further: GAOThe CMS needs to further adjust pay rates for Medicare Advantage plans, according to a government report, to more accurately reflect their beneficiaries' health and to avoid overpaying for the care of patients who are not as ill as the insurers claim. Continue reading this story...(registration required)
State Progress Toward Health Reform Implementation
Slower Moving States Have Much to Gainby Blavin F, Buettgens M and Roth JAn issue brief funded by the Robert Wood Johnson Foundation as part of its Quick Strike Series examines whether there is a correlation between the progress that states have made toward establishing the health insurance exchanges called for under the Affordable Care Act (ACA), and the expected benefits for state residents. Continue reading this story...
FDA's Mission Has Been Compromised, GAO Healthcare Director SaysAccording to Marcia Crosse (Director, Health Care at GAO), FDA's ability to fulfill its mission to protect American health has been compromised. In her comments on why oversight of medical devices was placed on GAO's High-Risk List, she says: "The Food and Drug Administration plays a key role in protecting the health of all Americans. FDA's role is far-reaching: from over-the-counter pain relievers to vaccines to prescription drugs to every medical device in your doctor's office or your local hospital. FDA is responsible for assuring the safety and effectiveness of every medical product before it is approved. After approval, FDA has a duty to ensure the continuing safety of hundreds of thousands of different medical products, regardless of whether they are manufactured here or abroad, and more than eight million shipments of medical products arrive at US ports in a single year. But, FDA is having difficulties in meeting its responsibilities." Continue reading this story...
Is Personalized Medicine In Your Future?
Proponents say the marriage of health IT and individualized therapy will revolutionize health care. The jury is still out.by Paul CerratoThe teaser at the top of a recent Wall Street Journal article proclaimed, "What does the future of medicine hold? Tiny health monitors, tailored therapies--and the end of illness." Whoa! IT-enhanced personalized medical therapy holds great promise, but we won't be eliminating disease from the face of the earth any time soon. Nature is much too smart to let that happen. Continue reading this story...
New Group To Set Priorities for Medical Effectiveness Research
But That May Be The Easy Partby Julie ApplebyMore than two years ago, studies found that injection of medical cement into compression fractures of the spine produced no better pain relief than "sham" injections. Yet doctors continue to perform the $5,000-plus procedure and most insurers, including Medicare, still cover it. Continue reading this story...
Important Research From Medicare Demonstration Projects: Almost Nothing WorksI will suggest that most of us believe the way to control health care costs, and at the same time maintain or improve quality, is to both use the managed care tools we have developed over the years, and perhaps more importantly, change the payment incentives so that both cost control and quality are upper most in the minds of providers and payers.The Congressional Budget Office (CBO) has just released an important review of Medicare's results in testing those ideas. The news is not good. Continue reading at the Healthcare Policy and Marketplace blog...
CMS proposes to change definition of uninsured for determining DSH paymentsCMS (Baltimore, MD) proposed a change in the definition of uninsured for the purpose of determining disproportionate share hospital (DSH) payments based on whether the patients were covered for the specific services provided by a hospital. The current definition of uninsured patients says that a patient is insured if they have any active insurance coverage, regardless of whether their insurance covers the specific services provided.
This definition excludes from uncompensated care the costs of many services that were provided to individuals with insurance coverage but were outside the scope of coverage. The proposed change also would consider DSH payments for any service provided that is not covered by an insurance policy because it exceeds a policy's annual or lifetime limits. The National Association of Public Hospitals and Health Systems (Washington, DC) (NAPH) will submit comments to CMS during the 30-day comment period, on the three types of costs that are still excluded from DSH payments that it would like to see included. These include unpaid co-payments and deductibles; payments that have been administratively denied; and cost of care to prisoners. For the third category, the uncompensated care cost can be included in the DSH limit only for those inmates who have been released from secure custody.
Department of Health and Human Services (HHS) noticeA January 4, 2012 Department of Health and Human Services (HHS) notice announces the  initial core set of health care quality measures for Medicaid-eligible adults under section 2701 of the ACA. The quality measures are available for voluntary use by state Medicaid programs, health insurance issuers and managed care entities that enter into contracts with Medicaid, and Medicaid providers. The core set includes 26 quality measures addressing: prevention and health promotion, management of acute and chronic conditions, family experiences of care, care coordination, and availability of services.
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