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Ga. Docs Collaborate on EHRs

Georgia physicians are collaborating with the state's Department of Community Health on adoption of Medicare electronic health records, the department said. The department intends to apply to the Centers for Medicare and Medicaid Services to participate in an EHR demonstration project, and department officials said they met with Georgia physicians in March to develop the program. Over a 5-year period, the demonstration project will provide financial incentives to small and medium-size physician groups using certified EHRs to meet certain clinical measures. Bonuses will be provided each year, based on a physician group's score on a standardized survey that assesses the specific EHR functions a group employs to support the delivery of care.

Consumer-Directed Enrollment Low

More employers are offering consumer-directed health plans in efforts to shift greater responsibility to workers for health care costs, lifestyle choices, and treatment decisions, according to a new survey on the plans. However, enrollment still constitutes only a small percentage of those enrolled in all employer-sponsored health plans, because large employers have not yet structured their premium contributions to favor the consumer-directed options, according to the survey from the Center for Studying Health System Change. Survey respondents were optimistic that consumer-directed health plans would become more prominent in health benefit offerings, but the report said plans and employers seeking to foster greater enrollment may need to make health savings accounts and health reimbursement arrangements more appealing to enrollees.

MA, Part D Changes Announced

The out-of-pocket threshold for a beneficiary enrolled in a standard Medicare Part D drug plan will rise from $4,050 to $4,350 next year, while the initial deductible rises from $275 to $295, CMS announced. The out-of-pocket threshold is the point at which the Part D “doughnut hole” is satisfied and Medicare begins paying for most drug expenses, minus 5% copayments. At the same time, health insurers running Medicare Advantage plans will see average increases of about 3.6% in capitation rates in 2009, CMS said. This increase in capitation rates is slightly lower than the estimated 3.7% Medicare growth trend for 2009, CMS said. In addition, CMS said it will audit records from a sample of Medicare Advantage plans in an effort to determine if the plans are reporting diagnosis code information correctly. Diagnosis code information is used in setting capitation and payment rates for the plans.

Workers Struggle With Health Costs

Almost all of those polled in a recent AFL-CIO survey said they were struggling with the cost of health care, even though most were insured and employed and more than half were in union jobs or were college graduates. One-third of respondents to the online survey, sponsored by the AFL-CIO and Working America, reported skipping medical care because of cost, and one-quarter had serious problems paying for the care they needed. In the past year, 76% of people who lacked insurance themselves and 71% of people with uninsured children said someone in their family did not visit a doctor when sick because of cost. In addition, about two-thirds of those without insurance reported skipping medical treatment or follow-up care, and more than half said they had to choose between paying for medical care or prescriptions and other essential needs, such as the rent, mortgage, or utilities. Nearly four out of five said health care is a very important voting issue.

Side Effects Underreported

One in six Americans who have taken a prescription drug experienced a side effect serious enough to send them to the doctor or hospital, but only 35% of consumers said they know they can report these side effects to the FDA, according to a Consumer Reports poll. Additionally, 81% of respondents said they had seen or heard an ad for prescription drugs within the last 30 days, almost all on television. Consumers Union, the nonprofit publisher of the magazine, gave the FDA a petition signed by nearly 56,000 consumers asking that a toll-free number and Web site be included in all television drug ads so people can easily report their serious side effects. “What better way for the FDA to let consumers know how to report serious problems with their medications than putting a toll-free number and Web site in all those drug ads we're bombarded by each day?” asked Liz Foley, campaign coordinator with Consumers Union, in a statement.

AAMC Adopts Medical Home

The Association of American Medical Colleges has adopted a formal position stating that every person should have access to a medical home. “We believe the medical home model holds great promise for improving Americans' health by ensuring that they have an ongoing relationship with a trusted medical professional,” Dr. Darrell Kirch, AAMD president and CEO, said in a statement. The AAMC position also said that further research and evaluation of the medical home model is needed and more evidence must be gathered on how the model is best implemented. In addition, payment for the model should “appropriately recognize and reward providers for prevention, care delivery, and coordination,” and “health care providers should be trained to understand and implement the medical home model within a team environment,” the AAMC said.

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