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Building A Better Path From School To College And Careers [August 8, 2008] Rising Rates Of Chronic Health Conditions: What Can Be Done? [August 7, 2008] Descriptive Summary Of 2003-04 Beginning Postsecondary Students: Three Years Later [August 6, 2008] Medicare Program Vulnerable To Fraud [August 5, 2008] Analysis of BLS Health Occupation Projections [August 4, 2008] Medical Cost Trends For 2009 [August 1, 2008] Medicare Spending Across The Map [July 31, 2008] Higher Education Act Ready To Be Cleared [July 30, 2008] What Should The Next U.S. President Do About Health Care Costs? [July 29, 2008] Learning Accountability From Bologna: A Higher Education Policy Primer [July 28, 2008] Evidence On The Costs And Benefits Of Health Information Technology [July 25, 2008] Investments In Disease Prevention Yield Significant Savings [July 24, 2008] Overuse, Underuse, And Misuse Of Health Care [July 23, 2008] Results From The National Scorecard on U.S. Health System Performance, 2008 [July 22, 2008] Addressing The Health Workforce Crisis [July 21, 2008] BLS Publication Features Allied Health Occupations [July 18, 2008] Acupuncture Substitutes For Some Conventional Medicine [July 17, 2008] Key National Indicators of Children's Well-Being [July 16, 2008] Assessing The Impact Of The Spellings Commission [July 15, 2008] Bad Behavior Among Health Professionals Threatens Patient Care [July 14, 2008] Legislation Protects Access To Therapy Services [July 11, 2008] VA's Efforts To Provide Culturally Appropriate Health Care To A Diverse Population [July 4, 2008] Medical Cost Trends For 2009 [July 3, 2008] Dental Hygiene Education Program Director Survey [July 2, 2008] Congress Fails to Prevent Therapy Cuts In Medicare [July 1, 2008] Designing New Approaches To Increase Nurse Education Capacity [June 30, 2008] Americans' Access To Medical Care Deteriorates Between 2003 And 2007 [June 27, 2008] Annual Research Meeting Videocasts And Transcripts Available [June 26, 2008] Neglected Infections Of Poverty In The U.S. [June 25, 2008] Most Physicians Not Yet Using Electronic Health Records [June 24, 2008] How The Internet Influences Americans' Health Attitudes And Actions [June 23, 2008] HIPAA Creating Barriers To Research And Discovery [June 20, 2008] Challenges And Successes In Reducing Health Disparities [June 19, 2008] Federal Reserve Chairman Discusses Challenges For Health Care Reform [June 18, 2008] University Of Phoenix As A National Community College? [June 17, 2008] The Economic Impact Of Aging U.S. Baby Boomers [June 16, 2008] Life Expectancy in U.S. Reaches Record High [June 13, 2008] Health Care Reform In Massachusetts [June 12, 2008] Medicare Clarifies Therapy Cap Implementation [June 11, 2008] Increasing Transparency In the Pricing Of Health Care Services [June 10, 2008] Disparities In Health And Health Care Among Medicare Beneficiaries [June 9, 2008] Ranking The States On Children's Health Care [June 6, 2008] AOTA Introduces New Brand [June 5, 2008] Post-Secondary Institutions' Enrollment, Graduation Rates, and Financial Statistics [June 4, 2008] How Well Do Journalists Cover Health Stories? [June 3, 2008] Adult Learning In Focus [June 2, 2008] Building A Better Path From School To College And Careers How can high schools, community colleges, four-year-colleges, and technical schools collaborate to create better college and career paths for high school students? A report from the Southern Regional Education Board (SREB) has tackled this question, summarizing the insights of 500 participants in 15 state-level forums, made up of high school principals, community college presidents, business leaders, state education commissioners and more. The report, Lost in Transition: Building a Better path from School to College and Careers, includes recommendations for collaboration among school systems, community colleges, and others, as well as details on successful efforts in the states. The report can be accessed by clicking http://www.sreb.org/publications/2008/08V01_LostInTransition.pdf . Rising Rates Of Chronic Health Conditions: What Can Be Done? The Center for Studying Health System Change (HSC) sponsored a conference on the topic of Rising Rates of Chronic Health Conditions: What Can Be Done? The growing prevalence of chronic conditions has added cost to the United States health care system. Prevention and better management of chronic conditions are often cited as ways to improve health outcomes and slow U.S. health care spending growth or at least generate better value for the $2.1 trillion spent annually on health care in this country. The conference aimed to provide an overview of the causes, costs, and consequences of rising rates of chronic conditions and some possible policy approaches to address what is clearly a significant public health problem. Slides and transcripts of presentations can be accessed by clicking http://www.hschange.org/CONTENT/1002/ . Descriptive Summary Of 2003-04 Beginning Postsecondary Students: Three Years Later Using data from the 2004/06 Beginning Postsecondary Students Longitudinal Study by the National Center for Education Statistics (NCES), this report provides a description of the characteristics and enrollment patterns of a nationally representative sample of students who began postsecondary education for the first time during the 2003-04 academic year. The report describes the background, academic preparation, and experience of these beginning students over three academic years, from July 2003 to June 2006, and provides information about their rates of persistence, program completion, transfer, and attrition. The focus is on differences among students beginning at either four-year, two-year, or less-than-two-year institutions. The report can be accessed by clicking http://nces.ed.gov//pubs2008/2008174.pdf. Medicare Program Vulnerable To Fraud According to the Department of Health and Human Services (HHS), schemes to defraud the Medicare program have grown more elaborate in recent years. In particular, HHS has acknowledged Centers for Medicare & Medicaid Service's (CMS) oversight of suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) is inadequate to prevent fraud and abuse. Specifically, weaknesses in the DMEPOS enrollment and inspection process have allowed sham companies to bill Medicare fraudulently for unnecessary or nonexistent supplies. From April 2006 through March 2007, CMS estimated that Medicare improperly paid $1 billion for DMEPOS supplies--in part due to fraud by suppliers. Government Accountability Office (GAO) investigators easily set up two fictitious DMEPOS companies using undercover names and bank accounts. GAO's fictitious companies were approved for Medicare billing privileges despite having no clients and no inventory. CMS initially denied GAO's applications in part because of this lack of inventory, but undercover GAO investigators fabricated contracts with nonexistent wholesale suppliers to convince CMS and its contractor, the National Supplier Clearinghouse (NSC), that the companies had access to DMEPOS items. If real fraudsters had been in charge of the fictitious companies, they would have been clear to bill Medicare for potentially millions of dollars worth of nonexistent supplies. The GAO report can be accessed by clicking http://www.gao.gov/new.items/d08955.pdf . Analysis of BLS Health Occupation Projections A report prepared by the Center for Health Workforce Studies at the University at Albany, State University of New York presents a summary of labor projections for the period 2006 through 2016 for health care settings and health care occupations. Every two years, the federal Bureau of Labor Statistics (BLS) publishes occupational and industry projections for employment in the United States for the coming decade. Projections by sector and by occupation for the period 2006 through 2016 were released in November 2007. The Center analyzed these projections and summarized the most significant findings related to health care employment. The report in the form of a PDF document can be accessed by pasting the following in the URL box C:\DOCUME~1\TOM~1.ASA\LOCALS~1\Temp\blsproj2008.zip. A new report from PriceWaterhouseCoopers indicates that healthcare costs continue to outpace the rate of inflation, but the silver lining is that since 2003 the percentage rate of increases has diminished each year. According to employers and health plans, that trend is predicted to level off in 2009 and premium increases should be expected in the future. Changes in patient behavior and new technology have helped to limit recent medical cost increases in the recent past, but these are being offset by multiple factors which are expected to reverse past trends and help drive medical cost increases in 2009. The report can be accessed by clicking http://pwchealth.com/cgi-local/hregister.cgi?link=reg/numbers2009.pdf . Medicare Spending Across The Map The baby boomers' imminent retirement and the continued rise in health care costs will force Medicare to the forefront of upcoming policy discussions. The Medicare Trustees and the Congressional Budget Office both predict that Medicare spending as a percentage of gross domestic product (GDP) will double by 2030. One possible avenue for reform is seen in the wide regional variations in Medicare spending that exist and have persisted through time. If Medicare reimbursements could be constrained to the levels existing in the lower cost areas, the program's costs could be reduced significantly, but why do Medicare costs vary so dramatically from area to area? A study released this month by the national Center for Policy Analysis examines county-by-county variation in Medicare spending, looks for causes of this variation, and suggests reforms that can narrow the variation that can't be explained by such causes. The study can be accessed by clicking http://www.ncpa.org/pub/st/st313/st313.pdf . Higher Education Act Ready To Be Cleared On July 31, Congress may clear the first major overhaul in a decade of the law governing federal aid to higher education. The Higher Education Act has not undergone a complete overhaul since 1998 (PL 105-244). Last year, Congress enacted legislation to curb subsidies to lenders and reduce interest rates on student loans (PL 110-84). Earlier this week, the Senate passed yet another short-term extension of the Higher Education Act to allow time for the paperwork and enrollment needed for the overhaul bill to reach the White House for President Bush's signature. The extension (S 3352), the year's eighth, would keep programs authorized under the existing law for two weeks after the current stopgap expires July 31. The agreement would cut off states' access to College Access Challenge Grants if their investments in higher education dip below the average level for the previous five years. That level would not include capital expenditures or money allocated for research and development. The legislation also would authorize year-round Pell grants and eliminate rules that limit the amount of Pell funds available to students attending the least-expensive schools. It also would increase the maximum Pell grant awards from $4,800 to $6,000 for 2009 and to $8,000 for 2014. What Should The Next U.S. President Do About Health Care Costs? AARP's Public Policy Institute sponsored a Solutions Forum on June 13, 2008, to look at policy options for dealing with rising health care costs. Julie Rovner of National Public Radio moderated a discussion among John Rother, executive vice president of AARP; David Cutler from Harvard University, an advisor to the Barack Obama campaign; and Tom Miller from the American Enterprise Institute, an advisor to the John McCain campaign. A report of the discussion can be accessed by clicking Learning Accountability From Bologna: A Higher Education Policy Primer Evidence On The Costs And Benefits Of Health Information Technology Peter Orszag, Director of the Congressional Budget Office (CBO), testified before the U.S. House Ways and Means Subcommittee on Health on July 24 on the topic of Evidence on the Costs and Benefits of Health Information Technology . His testimony can be accessed by clicking http://www.cbo.gov/ftpdocs/95xx/doc9572/07-24-HealthIT.pdf . Investments In Disease Prevention Yield Significant Savings A report released by Trust for America's Health (TFAH) in July 2008 finds that a small strategic investment in disease prevention could result in significant savings in U.S. health care costs. In its report, entitled Prevention for a Healthier America: Investments in Disease Prevention Yield Significant Savings, Stronger Communities , TFAH concluded that an investment of $10 per person per year in proven community-based programs to increase physical activity, improve nutrition, and prevent smoking and other tobacco use could save the country more than $16 billion annually within five years, a return of $5.60 for every $1 spent. The report can be accessed by clicking Overuse, Underuse, And Misuse Of Health Care Peter R. Orszag, Director of the Congressional Budget Office (CBO, testified before the U.S. Senate Finance Committee on July 17 on the Overuse, Underuse, and Misuse of Health Care. A copy of his testimony can be accessed by clicking http://www.cbo.gov/ftpdocs/95xx/doc9567/07-17-HealthCare_Testimony.pdf . Results From The National Scorecard on U.S. Health System Performance, 2008 In its first health system scorecard released two years ago, The Commonwealth Fund Commission on a High Performance Health System found that the United States fell far short of benchmarks for access, quality, efficiency, and other key measures of health system performance. The 2008 edition of the scorecard paints an even bleaker picture, with the U.S. scoring an average of 65 out of a possible 100 across 37 indicators—slightly below the overall score in the 2006 report. The report can be accessed by clicking http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=692682
Addressing The Health Workforce Crisis Out of Order, Out of Time: The State of the Nation's Health Workforce is a report undertaken by the Association of Academic Health Centers (AAHC) to focus attention on the critical need for a new, collaborative, coordinated, national health workforce planning initiative. The report is based on the following premises: The dysfunction in public and private health workforce policy and infrastructure is an outgrowth of decentralized decision-making in health workforce education, planning, development, and policymaking ( out of order ); The costs and consequences of our collective failure to act effectively are accelerating due to looming socioeconomic forces that leave no time for further delay ( out of time ); Cross-cutting challenges that transcend geographical and professional boundaries require an integrated and comprehensive national policy to implement effective solutions; Issues and problems outlined in the report have not been effectively addressed to date because of the inability of policymakers at all levels to break free from the historic incremental, piecemeal approaches; and Despite many challenges, the prospects for positive change are high. The report can be accessed by clicking http://www.aahcdc.org/policy/AAHC_OutofTime_4WEB.pdf . BLS Publication Features Allied Health Occupation The Summer 2008 issue of Occupational Outlook Quarterly , a publication of the Bureau of Labor Statistics (BLS), contains an article entitled “Health Care Jobs You Might Now About.” Two of the three occupations featured are surgical technology and cytotechnologists. The publication can be accessed by clicking http://stats.bls.gov/opub/ooq/2008/summer/art03.pdf . Acupuncture Substitutes For Some Conventional Medicine Around one percent of the U.S. population turns to acupuncture to improve health. In recent years, utilization, spending, and research related to acupuncture have increased significantly. Little is known, however, about how people actually use acupuncture in relation to conventional health care. Is acupuncture used in addition to conventional care, with the potential to increase health care costs, or is it a substitute, with the potential to decrease costs? The answers are of interest to insurers, health care practitioners, and policymakers. A RAND researcher was part of a team that examined utilization and expenditure patterns in medical and drug claims data on 17,970 individuals, including 1,688 acupuncture users, from a midsize metropolitan insurance company. The team found that acupuncture substituted for a range of services, including primary care, all outpatient services, pathology services, all surgery, and gastrointestinal medications. These and related findings indicate that acupuncture expenditures may be offset through reductions in the use of possibly more expensive conventional medical services, thus countering insurance companies' fears of covering acupuncture because of increased costs. A Fact Sheet containing more information can be accessed by clicking Key National Indicators of Children's Well-Being The Federal Interagency Forum on Child and Family Statistics, a collection of 22 Federal government agencies, including the National Center for Education Statistics (NCES), involved in research and activities related to children and families, has just released America's Children in Brief: Key National Indicators of Well-Being, 2008 . The report continues the tradition of cooperation and commitment by agencies across the Federal Government to advance an understanding of children today and indicate what may be needed to bring them a better tomorrow. The report can be accessed by clicking http://www.childstats.gov/americaschildren/index.asp . Assessing The Impact Of The Spellings Commission The National Association of College and University Business Officers is publishing a report today entitled, “Assessing the Impact of the Spellings Commission: The Message, the Messenger, and the Dynamics of Change in Higher Education.” The document reviews the commission's genesis, deliberations, and recommendations in 2005-6; the Education Department's efforts to carry out the panel's work over the last two years; and the responses of those within higher education to all the aforementioned. The report was released just as Education Secretary Margaret Spellings is about to convene a summit in Chicago later this week at which she is expected to try to urge higher education leaders to continue (after the Bush administration leaves office) to pursue the work they have undertaken consistent with the commission's report. The report can be accessed by clicking http://www.nacubo.org/documents/business_topics/AssessingImpact.pdf . Bad Behavior Among Health Professionals Threatens Patient Care Health care is a high-stakes, pressure-packed environment that can test the limits of civility in the workplace. A new alert issued by The Joint Commission warns that rude language and hostile behavior among health care professionals goes beyond being unpleasant and poses a serious threat to patient safety and the overall quality of care. Intimidating and disruptive behaviors are such a serious issue that, in addition to addressing it in the new Sentinel Event Alert , The Joint Commission is introducing new standards requiring more than 15,000 accredited health care organizations to create a code of conduct that defines acceptable and unacceptable behaviors and to establish a formal process for managing unacceptable behavior. The new standards take effect January 1, 2009 for hospitals, nursing homes, home health agencies, laboratories, ambulatory care facilities, and behavioral health care facilities across the United States. The alert can be accessed by clicking http://www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_40.htm . Legislation Protects Access To Therapy Services Congress passed the Medicare Improvements for Patients & Providers Act (H.R. 6331) with a veto proof majority of 69-30 in the Senate, granting an 18-month extension of the Medicare Part B outpatient therapy exceptions process. The bill, which was overwhelmingly passed by the House of Representatives by a vote of 355-59 on June 24, will prevent more than 700,000 Medicare beneficiaries from exceeding their limit on Part B outpatient therapies. The bill was sent on July 9 to the President for his signature. VA's Efforts To Provide Culturally Appropriate Health Care To A Diverse Population The Department of Veterans Affairs (VA) faces challenges in bridging language and cultural barriers as it seeks to provide quality health care services to an increasingly diverse veteran population. To meet the needs of veterans with limited English proficiency (LEP), VA issued an LEP Directive that provides guidance for medical centers in assessing language needs and, if needed, developing language access services designed to ensure effective communication between English-speaking providers and those with LEP. In addition, VA is also challenged to deliver health care services in ways that are culturally appropriate--that is, respectful of and responsive to the cultural values of a diverse veteran population. In light of these challenges, the Government Accountability Office (GAO), the congressional watchdog agency, was asked to discuss the (1) actions VA has taken to implement its LEP Directive and the status of veterans' utilization of language access services, and (2) efforts VA has made to provide culturally appropriate health care services. GAO reviewed VA's policies and the LEP Directive, interviewed VA officials and reviewed efforts by 6 VA medical centers and 10 other VA facilities to implement VA's LEP Directive and to provide culturally appropriate health care services. GAO also reviewed documents from 17 other VA medical centers related to implementation of the LEP Directive. The GAO report can be accessed by clicking http://www.gao.gov/new.items/d08535.pdf . According to a new report from PriceWaterhouseCoopers, health care costs continue to outpace the rate of inflation, but the silver lining is that since 2003 the percentage rate of increases has diminished each year. According to employers and health plans, that trend is predicted to level off in 2009 and premium increases should be expected in the future. Changes in patient behavior and new technology have helped to limit recent medical cost increases in the recent past, but these are being offset by multiple factors which are expected to reverse past trends and help drive medical cost increases in 2009. The report can be accessed by clicking http://pwchealth.com/cgi-local/hregister.cgi?link=reg/numbers2009.pdf. Dental Hygiene Education Program Director Survey A survey of dental hygiene education program directors is available. It contains over 800 data points and up-to-date information about the education programs and their faculty and staff, student demographics, and job markets for dental hygienists. The executive summary highlights survey responses relevant to critical dental hygiene issues identified in the 2005 report, Focus on Advancing the Profession . The new report can be accessed by clicking http://www.adha.org/downloads/AD-exec_report-2008.pdf . Congress Fails to Prevent Therapy Cuts In Medicare Congress recently adjourned for a 10-day July 4 recess after the Senate fell one vote short of the 60 votes needed to take up a House-passed bill (HR 6331) preventing cuts in Medicare fee schedule payments and the expiration of the therapy cap exceptions process. As a result, physical therapists and other providers face a 10.6% cut in the Medicare fee schedule conversion factor, which could mean payment cuts of roughly 16% in some geographic areas. In addition, patients will have all therapy services provided since January 1 counted toward the $1,810 financial limit on physical therapy and speech language pathology services for 2008, even if services provided in the first six months of the year qualified for an exception to the cap. Designing New Approaches To Increase Nurse Education Capacity A report released by the AARP, Robert Wood Johnson Foundation, and U.S. Department of Labor highlights new approaches to increasing capacity at the nation's nursing schools, which annually turn away thousands of qualified candidates due to a shortage of faculty. The June 27 report was released as part of a two-day summit, where stakeholder groups shared best practices to expand nursing education and foster action in four key areas: strategic partnerships; policy and regulation; faculty capacity and diversity; and education redesign. The report can be accessed by clicking http://www.championnursing.org/uploads/NursingEducationCapacityWhitePaper20080618.pdf . Americans' Access To Medical Care Deteriorates Between 2003 And 2007 More than 20 percent of the U.S. population in 2007—one in five individuals—reported not getting or delaying needed medical care in the previous 12 months, up significantly from 14 percent—one in seven—in 2003, according to a national study released on June 26 by the Center for Studying Health System Change (HSC). The proportion of Americans reporting an unmet medical need between 2003 and 2007 increased by 2.8 percentage points to 8 percent—the equivalent of about 9.5 million more persons going without medical care. During the same period, the proportion of Americans delaying needed care increased by 3.9 percentage points to 12.3 percent, or about 13.5 million more individual postponing care. Access problems increasingly were cited cost as an obstacle to needed care, along with rising rates of health plan and health system barriers. The report can be accessed by clicking http://www.hschange.com/CONTENT/993/ . Annual Research Meeting Videocasts And Transcripts Available The Annual Research Meeting sponsored by AcademyHealth brings together health services researchers, providers, and key decision makers to address the challenges confronting the nation's health care delivery system. The recent meeting occurred on June 9-10 and featured presentations on the topics of Medicare, Medicaid, and health reform. Videocasts and transcripts can be accessed by clicking http://www.kaisernetwork.org/health_cast/hcast_index.cfm?display=detail&hc=2794 . Neglected Infections Of Poverty In The U.S. An article published in today's edition of the Public Library of Science reveals that i n the U.S., the mortality rate resulting from infectious diseases has declined precipitously over the course of the twentieth century and major scourges such as typhoid fever and malaria are no longer serious public health threats However, among the poorest populations living in the U.S. there remains highly prevalent a group of serious parasitic and bacterial diseases such as Chagas disease, cysticercosis, and toxocariasis which, like the neglected tropical diseases (NTDs), are characterized by their high prevalence, chronic and disabling features, and disproportionate effect on the poor. These infections occur outside of tropical regions of Africa, Asia, and Latin America, and are not well known to the US public-health community. They promote poverty because of their impact on child development, pregnancy outcomes, and worker productivity This review highlights the largely underappreciated burden of the neglected infections of poverty in the US and makes policy recommendations for addressing such health disparities. The article can be accessed by clicking http://www.plosntds.org/article/info%3Adoi%2F10.1371%2Fjournal.pntd.0000256 . Most Physicians Not Yet Using Electronic Health Records Only a small number of physicians use a comprehensive digital record keeping system, according to a study in a recent online edition of the New England Journal of Medicine. Four percent of physicians have fully functional electronic health records, or EHRs, and 13 percent have a basic system, according to the study titled "Electronic Health Record Adoption in the Ambulatory Setting: Findings from a National Survey of Physicians." Even among physicians in largest group size—where physicians are three times as likely to use basic EHR systems than their colleagues in practices of one to three—almost half did not have a digital record keeping system. Sixteen percent have bought an EHR system but haven't implemented it yet, and 26 percent said their practice would purchase an EHR system within two years, the study found. This could signal an increase in usage within the next three to five years. One of the major barriers to physicians adopting EHR is cost. Last week, the Department of Health and Human Services said it plans to establish a five-year, $150 million pilot project offering incentives to 12 cities and states to encourage physicians to adopt an EHR system. How The Internet Influences Americans' Health Attitudes And Actions According to researchers at the Pew Internet & American Life Project, 75% of adults in the U.S. go online and 80% of that group seeks health information. Consequently, Internet users in the general population are much more informed or misinformed as the case may because of this access. Health professionals also can be affected to the extent that patients obtain correct or incorrect information on the Web. Thus, it would behoove the health community of practitioners to be aware of these societal trends. More information about this topic can be accessed from a videocast of a presentation on June 10, 2008 at the National Institutes of Health, which can be accessed by clicking http://videocast.nih.gov/PastEvents.asp?c=998&s=21 . HIPAA Creating Barriers To Research And Discovery Recent findings from the Executive Leadership Group of Vice Presidents for Research of the Association of Academic Health Centers (AAHC) reveal that the Privacy Rule of the Health Insurance Portability and Accountability Act (HIPAA) has serious and often detrimental effects on biomedical research. It is known that the U.S. is a global leader in biomedical discovery and that research conducted at academic health centers has led to new lifesaving discoveries and treatments for disease and chronic illness. What is often not recognized beyond the research community is the negative impact—often unintended—of the myriad regulations and mandates such as HIPAA. Ultimately, societal interests are at stake when unintended barriers hamper research processes and progress. The AAHC learned from focus groups around the U.S. that one regulation in particular, HIPAA, continues to hamper a wide array of health research activities and corrective action is needed in order to advance biomedical research and science in the U.S. The AAHC report can be accessed by clicking http://www.aahcdc.org/policy/reddot/AAHC_HIPAA_Creating_Barriers.pdf . Challenges And Successes In Reducing Health Disparities In early 2007, the Institute of Medicine convened the Roundtable on Health Disparities to increase the visibility of racial and ethnic health disparities as a national problem, to further the development of programs and strategies to reduce disparities, to foster the emergence of leadership on this issue, and to track promising activities and developments in health care that could lead to dramatically reducing or eliminating disparities. The Roundtable's first workshop, Challenges and Successes in Reducing Health Disparities , was held in St. Louis, Missouri, on July 31, 2007 and examined the importance of differences in life expectancy within the United States, the reasons for those differences, and the implications of this information for programs and policy makers. A workshop report recently became available. The report can be accessed by clicking http://books.nap.edu/catalog.php?record_id=12154#toc . Federal Reserve Chairman Discusses Challenges For Health Care Reform Earlier this week, U.S. Federal Reserve Board Chair Ben Bernanke stated that improving health care system performance is among the country's most critical challenges and that efforts must focus on access, quality, and cos t . He spoke at the "Health Reform Summit" held at the Library of Congress and sponsored by the Senate Finance Committee. Indicating that health care spending comprises more than 15% of the U.S. economy and is the "single largest component of personal consumption, larger than spending on either housing or food," he noted that if the pace continues, health spending will exceed 22% of gross domestic product by 2020 and represent 50% of all federal spending by 2050. "Taking on these challenges will be daunting," and we "should not expect a single set of reforms to address all concerns. Rather, an eclectic approach will probably be needed." Rising federal spending on health care will require cuts in other government programs, higher taxes or increased budget deficits, according to Bernanke. His remarks can be accessed by clicking http://www.federalreserve.gov/newsevents/speech/bernanke20080616a.htm . University Of Phoenix As A National Community College? Today's issue of Inside Higher Ed contains an item on the University of Phoenix. With more than 100,000 individuals now enrolled in its young two-year degree granting college, Axia, has it morphed into a national community college, too? The number of associate degrees awarded by the for-profit Phoenix swelled to 13,000 in 2007, just three years after Axia's establishment in 2004. The all-online college now offers associate of arts degrees in fields including accounting, communication, health care administration, information technology, and paraprofessional education. Students take two courses at a time in nine-week blocks. The article can be accessed by clicking http://www.insidehighered.com/news/2008/06/17/phoenix . The Economic Impact Of Aging U.S. Baby Boomers Despite their aggregate wealth, a vast majority of U.S. Baby Boomers are unprepared for retirement. According to a new report from McKinsey & Co., enabling them to work longer would significantly benefit both individuals and the broader economy, but policy makers and business leaders will need to take action. The report can be accessed by clicking Life Expectancy in U.S. Reaches Record High Life expectancy for U.S. residents reached a record high of 78.1 years in 2006, compared with a previous record high of 77.8 years in 2005, according to a preliminary report released by the National Center for Health Statistics at CDC. According to the report, life expectancy was 80.7 years for women and 75.4 years for men. White women had the longest life expectancy at 81 years followed by black women at 76.9 years, white men at 76 years, and black men at 70 years. The disparity in life expectancy between whites and blacks has decreased in recent years because of improvements in treatment for heart disease, which affects a higher percentage of blacks. The report can be accessed by clicking http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_16.pdf . Health Care Reform In Massachusetts In April 2006, Massachusetts passed legislation intended to move the state to almost universal coverage within three years and, in conjunction with that expansion, to improve access to affordable, high-quality health care. In roughly the first year under reform, uninsurance among working-age adults was reduced by almost half among those surveyed, dropping from 13% in Fall 2006 to 7% in Fall 2007. At the same time, access to care improved and the share of adults with high out-of-pocket costs and problems paying medical bills dropped. Despite higher than anticipated costs, most residents of the state continued to support reform. The report can be accessed by clicking Medicare Clarifies Therapy Cap Implementation If Congress fails to pass legislation by June 30 extending the current exceptions process, all physical therapy services provided to Medicare beneficiaries since January 1 will count toward the $1,810 therapy cap for 2008. The Centers for Medicare & Medicaid Services (CMS) released an MLNMatters article reminding physical therapists and other providers that the statutory authorization for the exceptions process will expire at the end of the month. If a beneficiary has already reached the therapy cap limit for 2008 on or after July 1, Medicare will no longer pay for the services unless they are provided in an outpatient hospital setting. Use of the KX modifier will not be effective on or after July 1, regardless of whether the patient had previously qualified for an exception to the therapy cap. The Balanced Budget Act of 1997 enacted financial limitations on outpatient physical therapy, occupational therapy, and speech-language pathology services in all settings except outpatient hospital services. The 2006 Deficit Reduction Act enacted further exceptions to the limits, and the Medicare, Medicaid, and SCHIP Extension Act of 2007 extended the cap exceptions process through June 30, 2008. CR 5871 announced the dollar amount of outpatient therapy caps for 2008. Effective January 1, 2008, the financial limits on outpatient therapy services were $1,810 for combined physical therapy and speech-language pathology services; and $1,810 for occupational therapy services. Exceptions are allowed for medically necessary outpatient therapy services in all settings for services furnished on or before June 30, 2008. Increasing Transparency In the Pricing Of Health Care Services The rising cost of health care represents the nation's single most important long-term fiscal challenge. A new brief from the Congressional Budget Office (CBO) explores whether increased transparency about prices for specific health care services and pharmaceuticals would help to temper the rapid growth in costs. The answer is unclear because evidence can be marshaled on both sides of the issue. The brief can be accessed by clicking http://www.cbo.gov/ftpdocs/92xx/doc9284/06-05-PriceTransparency.pdf . Disparities In Health And Health Care Among Medicare Beneficiaries A new report from The Dartmouth Institute for Health Policy & Clinical Practice demonstrates that in U.S. health care, it's not only who you are that matters, it's also where you live. Race and place of residence can have a significant effect on the quality of care a Medicare beneficiary receives. Blacks were found to be less likely than whites to receive recommended care within a given region, but greater disparities in care were found among different geographic regions, according to the study The findings highlight the importance of understanding health and health care within a local context – and of efforts to explore and address the underlying causes of disparities within and across regions. The report can be accessed by clicking http://www.dartmouthatlas.org/af4q/AF4Q_Disparities_Report.pdf . Ranking The States On Children's Health Care The first-ever state-by-state health system "scorecard" on children's health care finds wide differences across the country in the quality of care delivered as well as disparities in access to services, insurance costs, and health outcomes. According to the report by The Commonwealth Fund, millions more children would have insurance and adequate health care and would avoid developmental delays if all states performed as well as Iowa, Vermont, Maine, Massachusetts, and New Hampshire. The report can be accessed by clicking http://www.commonwealthfund.org/usr_doc/Scorecard_child_05-27-08.pdf?section=4039 . The American Occupational Therapy Association (AOTA) recently introduced a new brand-- “Living Life To Its Fullest. It is viewed as differentiating the profession from other disciplines that may appear similar in features, attributes, and possibly even benefits. Over the next several months, AOTA will develop communication tools and begin to use the brand as part of its advocacy with policymakers, in targeted advertising to increase AOTA's profile, in speaking with students interested in entering the field, in discussions with reporters, and many other activities. Post-Secondary Institutions' Enrollment, Graduation Rates, and Financial Statistics This First Look presents findings from the Integrated Postsecondary Education Data System (IPEDS) spring 2007 data collection, which included four components: Enrollment in Postsecondary Institutions, Fall 2006; Graduation Rates, 2000 & 2003 Cohorts; and Financial Statistics, Fiscal Year 2006. These data were collected through the IPEDS web-based data collection system. Findings include: In fall 2006, Title IV institutions in the United States enrolled a total of 18 million individual graduate and undergraduate students; 62 percent were enrolled in 4-year institutions, 37 percent in 2-year institutions, and 2 percent in less-than-2-year institutions. Graduation rates of bachelor's-seeking students at 4-year institutions were higher at private not-for-profit institutions than at public or private for-profit institutions. For example, the 4-year graduation rate of all bachelor's-seeking students was 50 percent at private not-for-profit institutions, 29 percent at public institutions, and 26 percent at private, for-profit institutions. During 2005-06 academic year, 75 percent of the 2.7 million full-time, first-time degree/certificate-seeking undergraduates attending Title IV institutions located in the United States received financial aid. The report can be accessed by clicking http://nces.ed.gov/pubs2008/2008173.pdf . How Well Do Journalists Cover Health Stories? The daily delivery of news stories about new treatments, tests, products, and procedures may have a profound—and perhaps harmful—impact on health care consumers. A US Web site project, HealthNewsReview.org modeled after similar efforts in Australia and Canada, evaluates and grades health news coverage, notifying journalists of their grades. After almost two years and 500 stories, the project has found that journalists usually fail to discuss costs, the quality of the evidence, the existence of alternative options, and the absolute magnitude of potential benefits and harms. Reporters and writers have been receptive to the feedback. Editors and managers must be reached if change is to occur. Time (to research stories), space (in publications and broadcasts), and training of journalists can provide solutions to many of the journalistic shortcomings identified by the project. HealthNewsReview can be accessed by clicking http://HealthNewsReview.org/ . Jobs that are expected to support the U.S. economy in coming years will depend on a skilled workforce that is able to learn and adapt quickly to new challenges. However, demographic patterns demonstrate that relying on the traditional K–16 pipeline to meet the educational and workforce needs of the states and the nation will not be enough. In addition, economic and personal benefits that individuals gain from education also argue for greater focus and emphasis on adult learning. Yet not enough is known or publicized about the scope and potential of adult learning in the U.S. or about barriers to adult participation. While many colleges and universities have entered the market for adult students, and while some enlightened corporations have encouraged participation in education among their front-line employees as a strategic investment, both federal and state policy remain largely concerned with the traditional educational pipeline. A new report produced by the Council for Adult and Experiential Learning (CAEL), with funding from Lumina Foundation for Education and in partnership with the National Center for Higher Education Management Systems (NCHEMS), provides a comprehensive look at adult learning in America at the national and state levels. The report can be accessed by clicking http://www.cael.org/pdf/publication_pdf/State_Indicators_Monograph.pdf .
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