News Archive
Mediocre Massachusetts Health Report Card [July 22, 2011]
Assessing The Costs Of Racial And Ethnic Health Disparities: State Experience [July 21, 2011]
Advancing Health in Rural America: Maximizing Nursing’s Impact [July 20, 2011]
First Results From The 2010 Census [July 19, 2011]
Eliminating Health Disparities [July 18, 2011]
Health Literacy Implications For Health Care Reform: IOM Workshop Report [July 15, 2011]
IOM Report On Improving Access To Oral Health Care [July 14, 2011]
State Authorization Rule On Distance Education Online Programs [July 13, 2011]
Legal Issues In Faculty Retirement [July 12, 2011]
Adult Obesity Increasing [July 11, 2011]
The Health Insurance Experiment [July 8, 2011]
Public Ambivalence Over Remedies To Fix Financially Troubled Entitlement Programs [July 7, 2011]
NCQA Updates HEDIS Measures [July 6, 2011]
Massachusetts Health Plan Not Containing Health Care Costs [July 5, 2011]
Tuition Watch Lists Released [July 1, 2011]
HHS Issues Proposed Standards [June 30, 2011]
Security Gaps May Threaten Electronic Health Records [June 29, 2011]
National Prevention Strategy [June 28, 2011]
Obtaining Health Insurance Through Places Of Employment [June 27, 2011]
GAO Issues Report On Comparative Research Funding [June 17, 2011]
Health Care Costs 101 [June 16, 2011]
Enrollment In ACA Plan For Pre-Existing Conditions [June 15, 2011]
Reflections On 30 Years Of AIDS [June 14, 2011]
Parents Who Have Children With More Than One Partner [June 13, 2011]
Prospectors Hoping To Mine Opportunities From The Health Industry [June 10, 2011]
Infectious Disease Occurrence [June 9, 2011]
Integration Of Immigrants Into U.S. Society [June 8, 2011]
Snapshots Of State Health Quality [June 7, 2011]
Education Department Releases Final Gainful Employment Rule [June 6, 2011]
Description Of The Immigrant Population [June 3, 2011]
Evolving Models Of Behavioral Health Integration In Primary Care [June 2, 2011]
Academic Medicine Collection Highlights Comparative Effectiveness Research [June 1, 2011]
Mediocre Massachusetts Health Report Card
The “Healthy People/Healthy Economy Report Card” grades policies on 14 different health indicators in four key areas: physical activity, access to healthy foods, investments in health and wellness, and citizen education and engagement. The grades were mixed – no As, five Bs, two Cs, four Ds, and two Fs. The innovative report card by the Boston Foundation and the NEHO health policy foundation is the first in the nation to focus on the effectiveness of public policies that encourage healthy living and controlling and preventing obesity and other chronic illnesses. This first annual report card should serve as a template for other communities and states across the country seeking to hold public officials accountable for the effectiveness and direction of their wellness policies.
The report card can be accessed by clicking http://commonhealth.wbur.org/2011/07/massachusetts-health-report-card/.
Assessing The Costs Of Racial And Ethnic Health Disparities: State Experience
Health disparities cost the United States billions of dollars in direct medical expenditures in addition to the human costs. In an effort to improve quality and contain costs states are taking steps to measure these costs and address disparities. This issue brief, which features Virginia and Rhode Island, was prepared by the National Academy for State Health Policy (NAHSP) for the Agency for Healthcare Research and Quality (AHRQ). It focuses on tools, challenges, and strategies states use to measure the costs of health disparities.
The issue brief can be accessed by clicking http://www.nashp.org/sites/default/files/costs.ethnic.racial.disparities.pdf .
Advancing Health in Rural America: Maximizing Nursing’s Impact
An AARP Fact Sheet provides a link between evidence-based nursing solutions in the IOM Future of Nursing: Leading Change, Advancing Health report and health care challenges facing Americans in rural areas. It outlines the challenges of providing access to quality, affordable care in rural areas, followed by examples of initial progress in additional support to key programs. Nurses are limited in their full contributions in these programs because of practice barriers. Ample evidence shows that nurses can provide accessible, quality care to meet the complex care needs in rural areas.
The Fact Sheet can be accessed by clicking http://assets.aarp.org/rgcenter/ppi/health-care/fs227-nursing.pdf.
First Results From The 2010 Census
The Population Reference Bureau (PRB) recently published PRB Reports on America: "First Results From the 2010 Census," summarizing key findings from the first wave of data from the 2010 U.S. Census. The report discusses trends in U.S. population growth, the changing racial/ethnic characteristics of the population, and patterns of state and local population growth and decline.
The report can be accessed by clicking http://www.prb.org/pdf11/reports-on-america-2010-census.pdf .
Eliminating Health Disparities
Five national health care groups today issued a "call to action" to eliminate disparities in care. The Association of American Medical Colleges, American College of Healthcare Executives, American Hospital Association, Catholic Health Association of the United States, and National Association of Public Hospitals and Health Systems indicated the focus should be on increasing the collection and use of race, ethnicity and language preference data; increasing cultural competency training; and increasing diversity in governance and leadership. The groups created a new website through which they will share resources, best practices, and national collaborative efforts to eliminate disparities.
The site can be accessed by clicking http://www.equityofcare.org/resources.html.
Health Literacy Implications For Health Care Reform: IOM Workshop Report
The Patient Protection and Affordable Care Act (ACA) extends health care access to 32 million Americans who previously had been uninsured. Many newly eligible individuals who could benefit most from the benefits promised by the ACA are perhaps least prepared to take advantage of those benefits. Due to low health literacy, many individuals may have difficulty understanding what coverage they are eligible for under the ACA; making informed choices about what is best for them and their families; and completing the enrollment process. On November 10, 2010, the Institute of Medicine (IOM) Roundtable on Health Literacy held a workshop to explore opportunities to advance health literacy in association with the implementation of health care reform. Participants in the workshop examined ways to improve health literacy alongside efforts to expand coverage, provide equitable care, and improve health care quality.
The report can be accessed by clicking http://www.nap.edu/catalog.php?record_id=13056.
IOM Report On Improving Access To Oral Health Care
The Institute of Medicine (IOM) released a report on "Improving Access to Oral Health Care for Vulnerable and Underserved Populations". Access is essential to promoting and maintaining overall health and well-being, yet only half of the population visits a dentist each year. Poor and minority children are less likely to have access to oral health care than are their non-poor and non-minority peers. Many older adults also confront access barriers regardless of their financial resources. Consequences of these disparities can lead to conditions such as malnutrition, childhood speech problems, infections, diabetes, heart disease, and premature births.
The report can be accessed by clicking https://download.nap.edu/catalog.php?record_id=13116#toc.
State Authorization Rule On Distance Education Online Programs
A U.S. District Court judge for the District of Columbia struck down a portion of the Education Department's controversial "state authorization rule.” If implemented, the regulation would require colleges offering online programs to students in other states to seek approval from each of those states. Failure to do so would place them at risk of losing federal aid. Opponents in the form of organizations across the higher education spectrum viewed the rule as an overreach of federal power. They cited the cost of seeking authorization in every state where they enrolled students as a prohibitive factor. Many health professions educational programs across state lines are offered online. Complementing the concerns of higher education associations, the U.S. House of Representatives education committee approved a bill in June 2011 would repeal that rule and another rule that would set a federal definition of a credit hour and expand state oversight of colleges.
Legal Issues In Faculty Retirement
Higher education institutions face increasingly complex legal challenges since Congress ended mandatory retirement for tenured faculty in 1994. A publication released today by the American Council on Education (ACE) provides college and university presidents and cabinet members with guidance on these issues. "Supporting the Culminating Stages of Faculty Careers: Legal Issues," funded by the Alfred P. Sloan Foundation, includes case studies and an in-depth examination of civil rights, tax, and contract law. Institutions are urged to ensure that faculty retirement is a voluntary decision, to include clear language in plans and benefit programs, and to avoid age discrimination. The report also explores complex questions that can be raised by retirement incentive programs.
The report can be accessed by clicking http://www.acenet.edu/AM/Template.cfm?Section=Faculty_Career_Flexibility&Template=/CM/ContentDisplay.cfm&ContentID=41776.
Adult obesity rates increased in 16 states in the past year and did not decline in any state, according to F as in Fat: How Obesity Threatens America's Future 2011, a report from Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF). Twelve states now have obesity rates above 30 percent. Four years ago, only one state was above 30 percent.
The report can be accessed by clicking http://www.rwjf.org/files/research/tfahfasinfat2011a.pdf.
The Health Insurance Experiment
An idea that has returned to prominence is cost sharing, which involves shifting a greater proportion of health care expense and responsibility onto consumers. Recent public discussion of cost sharing often has cited a landmark RAND study: the Health Insurance Experiment (HIE). Although it was completed over two decades ago, in 1982, the HIE remains the only long-term, experimental study of cost sharing and its effect on service use, quality of care, and health. A research brief summarizes the HIE’s main findings and clarifies its relevance for today’s debate.
The issue brief can be accessed by clicking http://www.rand.org/content/dam/rand/pubs/research_briefs/2006/RAND_RB9174.pdf.
Public Ambivalence Over Remedies To Fix Financially Troubled Entitlement Programs
A survey conducted by the Pew Research Center shows that most Americans indicate that Social Security, Medicare, and Medicaid either need to be completely rebuilt or undergo major changes. The public's desire for fundamental change does not mean it supports reductions in the benefits provided by these programs. Relatively few are willing to see benefit cuts as part of the solution, regardless of whether the problem being addressed is the federal budget deficit, state budget shortfalls, or the financial viability of the entitlement programs.
Survey results can be accessed by clicking http://people-press.org/files/legacy-pdf/7-7-11%20Entitlements%20Release.pdf.
The National Committee for Quality Assurance (NCQA) has added two measures and retired one obsolete measure in the 2012 edition of the Healthcare Effectiveness Data and Information Set (HEDIS®) known as HEDIS 2012, Volume 2. The two new measures are (1) Human Papillomavirus Vaccine for Female Adolescents, which assesses the percentage of 13-year-old females who had three doses of the human papillomavirus (HPV) vaccine. (The measure evaluates compliance with Centers for Disease Control and Prevention and Advisory Committee on Immunization Practices immunization guidelines), and Medication Management for Individuals with Asthma, which assesses the percentage of individuals 5–64 years of age who were identified as having persistent asthma and who received and remained on appropriate medications during their treatment period. The obsolete measure, which will be removed, is Relative Resource Use for Individuals with Acute Low Back Pain.
Additional information can be obtained by clicking http://www.ncqa.org/tabid/1403/Default.aspx.
Massachusetts Health Plan Not Containing Health Care Costs
The Office of the Attorney General for the Commonwealth of Massachusetts has released a report entitled Examination of Health Care Cost Trends and Cost Drivers. It points out the challenges involved in increasing the scope of health insurance coverage while trying to control health care costs.
The Report can be accessed by clicking http://www.mass.gov/Cago/docs/healthcare/2011_HCCTD.pdf.
Yesterday, the National Center for Education Statistics (NCES) released its new college price watch lists. The lists, which were mandated by the 2008 Higher Education Opportunity Act, are broken down by nine different institution types into six lists: (1) the top five percent of the most expensive institutions in the most recent preceding academic year for which data are available, (2) the top five percent of the most expensive institutions by net price in the previous year, (3) the top five percent of institutions with the largest percentage increase in tuition and fees over the three previous years, (4) the top five percent of institutions with the largest percentage increase in net price over the three previous years, (5) the 10 percent of institutions with the lowest tuition and fees in the previous year, and (6) the 10 percent of institutions with the lowest net price in the previous year. The intention is to focus attention on institutions with rapid tuition increases to give families more information about the actual price they are likely to pay for college.
The list can be accessed by clicking http://collegecost.ed.gov/catc/Default.aspx.
The Department of Health and Human Services issued proposed standards yesterday for collecting and reporting data on race, ethnicity, sex, primary language and disability status, as required by the Patient Protection and Affordable Care Act. The proposed standards are intended to help federal agencies refine their population health surveys to better understand health disparities and how to eliminate them. HHS will accept comments on the draft standards through August 1. The agency also announced plans to integrate questions on sexual orientation into national data collection efforts by 2013 and begin a process to collect information on gender identity to identify health disparities in lesbian, gay, bisexual and transgender populations.
The proposed standards can be accessed by clicking http://www.regulations.gov/#!documentDetail;D=HHS-OMH-2011-0013-0001.
Security Gaps May Threaten Electronic Health Records
Two reviews raise significant concerns about the security of electronic patient health information - "Nationwide Rollup Review of the Centers for Medicare & Medicaid Services Health Insurance Portability and Accountability Act of 1996 Oversight" ("Nationwide Rollup") and "Audit of Information Technology Security Included in Health Information Technology Standards" ("HIT Standards"). High impact vulnerabilities include unencrypted laptops and portable drives containing sensitive personal health information, outdated antivirus software and patches, unsecured networks, and the failure to detect rogue devices intruding on wireless networks. These vulnerabilities placed the confidentiality, integrity, and availability of sensitive health information at risk.
Individual report summaries can be accessed by clicking http://oig.hhs.gov/oas/reports/other/180930160.asp and http://oig.hhs.gov/oas/reports/region4/40805069.asp.
The National Prevention and Health Promotion Strategy, a comprehensive plan that will help increase the number of Americans who are healthy at every stage of life, was released recently. It recognizes that good health comes not just from receiving quality medical care, but also from clean air and water, safe worksites and healthy foods. The strategy was developed by the National Prevention Council, which is composed of 17 federal agencies who consulted with outside experts and stakeholders. The Strategy was developed with guidance from the public and is supported by the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health as called for under the Affordable Care Act.
More information on the National Prevention Strategy and the National Prevention Council can be accessed by clicking www.HealthCare.gov/center/councils/nphpphc.
Obtaining Health Insurance Through Places Of Employment
The proportion of Americans who receive health insurance through their jobs declined by eight percentage points, or 7.3 million individuals, between 1999 and 2009, according to a report from the Robert Wood Johnson Foundation (RWJF). More than half of the decline occurred in families with moderate incomes. Nearly three-fifths of the decline was in dependent coverage. Prepared by the State Health Access Data Assistance Center at the University of Minnesota, the report shows large differences across states. In a separate RWJF report, the Urban Institute projects that the proportion of small firms (fewer than 100 workers) offering health coverage will increase by 9.7% under the Patient Protection and Affordable Care Act, to 47.6%.
The report can be accessed by clicking http://www.rwjf.org/files/research/72528shadac201106.pdf.
GAO Issues Report On Comparative Research Funding
The Government Accountability Office (GAO) on June 15 reported to Congress on the Department of Health and Human Services' funding of comparative effectiveness research under the American Recovery and Reinvestment Act and Patient Protection and Affordable Care Act. The report includes information on HHS expenditures using these funds, the funded entities and the purpose of the funding.
The report can be accessed by clicking http://www.gao.gov/new.items/d11712r.pdf .
Health Care Costs 101
In 2009, national health care spending grew at the slowest pace seen in half a century. The 4.0% increase over prior year spending extended a slowing trend that has been underway since 2003. The modest growth in health spending still outpaced the economy, however, and health care's share of GDP rose to 17.6%, a full percentage point above 2008. Total health care spending in 2009 reached $2.5 trillion, or $8,086 per person. Although the Great Recession came to an official close in mid-2009, it had a pronounced effect on the nation's health spending. Health Care Costs 101, part of the California HealthCare Foundation's California Health Care Almanac, provides general background information on U.S. health spending.
The report can be accessed by clicking http://www.chcf.org/~/media/Files/PDF/H/PDF%20HealthCareCosts11.pdf.
Enrollment In ACA Plan For Pre-Existing Conditions
More than 21,000 are enrolled in the Patient Protection and Affordable Care Act's Pre-existing Condition Insurance Plan, according to a report from the Commonwealth Fund. The program, which will expire with the creation of state-based insurance exchanges in 2014, offers health coverage to individuals with a pre-existing condition who have not had group health coverage for six months. The ACA allocated $5 billion to the program, which the Congressional Budget Office estimated might cover 200,000 people annually.
The report can be accessed by clicking
http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2011/Jun/1509_Hall_early_implementation_PCIP_613_v2.pdf
Reflections On 30 Years Of AIDS
On June 5, 1981, the Morbidity and Mortality Weekly Report (MMWR), published by the Centers for Disease Control and Prevention (CDC), described Pneumocystis carinii (now P. jiroveci) pneumonia in five homosexual men in Los Angeles, California, documenting for the first time what became known as acquired immunodeficiency syndrome (AIDS). The accompanying editorial suggested that the illness might be related to the men's sexual behavior. A month later, the MMWR reported additional diagnoses of P. carinii pneumonia, other opportunistic infections (OIs), and Kaposi sarcoma (KS) in homosexual men from New York City and California. These articles were sentinels for what became one of history's worst pandemics, with more than 60 million infections, 30 million deaths, and no end in sight. This 30th anniversary year of the first description of AIDS also is the 15th anniversary of the introduction of highly active antiretroviral therapy (ART). Henceforth, AIDS will have been a treatable condition longer than it was the inevitably fatal disease first recognized. Additional information is contained in an article appearing in the CDC journal Emerging Infectious Diseases.
The article can be accessed by clicking http://www.cdc.gov/eid/content/17/6/pdfs/1044.pdf .
Parents Who Have Children With More Than One Partner
How a child is reared can have an affect on health status. The most disadvantaged U.S. parents are also most likely to have children with more than one partner, creating complex family relationships and potentially exacerbating poverty according to a study reported in the 2010-2011 Policy Seminar Series of the Population Reference Bureau (PRB). Fathers who have a child with a new partner tend to reduce the time and money they spend on previous biological children. Children whose parents have offspring by other partners tend to show more "externalizing behaviors" such as acting out and aggression, which are related to dropping out of high school and delinquency later on.
The study can be accessed by clicking http://www.prb.org/Journalists/Webcasts/2011/multipartner-childbearing-policy-seminar.aspx.
Prospectors Hoping To Mine Opportunities From The Health Industry
Healthcare is expected to reach nearly 20% of the US gross domestic product by 2019 and is bursting with new products and services. PricewaterhouseCoopers (PwC) surveyed U.S. consumers and found they would be willing to spend more than $13 billion a year of their own money on those new services. It’s the promise of those new products and services that is enticing more and more businesses to turn to the U.S. health system as an opportunity for innovation, differentiation, and profits. With 76% of the Fortune 50 now in the health industry or with a health division, it is apparent that opportunity abounds.
The report can be accessed by clicking http://pwchealth.com/cgi-local/hregister.cgi?link=reg/the-new-gold-rush.pdf.
Despite the availability of vaccines to prevent certain diseases, not all Americans are willing to have their children inoculated. Measles, a highly contagious, but preventable disease, is making its appearance in the U.S. According to the CDC, cases reported in 23 states this year represent the largest incidence in the past 15 years. The disease can lead to hospitalization and even death.
The CDC report can be accessed by clicking http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6020a7.htm.
Integration Of Immigrants Into U.S. Society
Even though immigration is intertwined with the history of the United States, fears about immigrants' ability to integrate remain an area of concern. Yet an examination of immigrants’ integration across five major indicators – language proficiency, socioeconomic attainment, political participation, residential locale, and social interaction with host communities – shows they are integrating reasonably well according to a report from the Migration Policy Institute. The laissez faire policy approach to integration is examined, raising concerns about how the state of public education and size of the US unauthorized population may remain powerful barriers to immigrants' full social, economic, and political integration.
The report can be accessed by clicking http://www.migrationpolicy.org/pubs/integration-Jimenez.pdf.
Snapshots Of State Health Quality
The Agency for Healthcare Research and Quality (AHRQ) released "State Snapshots” of health care quality and disparities data, based on data from the agency's 2010 national reports on health care quality and disparities. The snapshots provide summary measures of quality by type of care (preventive, acute, and chronic), care setting (home health, hospital, nursing home, and ambulatory), and clinical area (cancer, diabetes, heart disease, maternal and child health, and respiratory diseases), and compare each state to others in its region and the nation.
Access to information about states can be obtained by clicking http://statesnapshots.ahrq.gov/snaps10/index.jsp.
Education Department Releases Final Gainful Employment Rule
Recently, the Obama Administration released final regulations requiring career college programs to prepare students better for "gainful employment" or risk losing access to federal student aid. While many career college programs are helping to prepare America's workforce for the jobs of the future, far too many students at these schools are taking on unsustainable debt in exchange for degrees and certificates that fail to help them obtain the jobs they need or were promised. These regulations are designed to ramp up over the next four years, giving colleges time to reform while protecting students and their families from exploitative programs.
The regulations can be accessed by clicking http://www2.ed.gov/policy/highered/reg/hearulemaking/2009/ge-unofficial-06032011.pdf.
Description Of The Immigrant Population
The most recent document in a series by the Congressional Budget Office (CBO) on immigration updates, A Description of the Immigrant Population, provides an overview of the nation's foreign-born population, with a particular focus on the years 2000 to 2009. It discusses changes in the numbers and countries of origin of the foreign-born and their U.S. residency and citizenship status. It also compares demographic and labor market characteristics of foreign-born and native-born individuals in the United States.
The report can be accessed by clicking http://www.cbo.gov/ftpdocs/121xx/doc12168/06-02-Foreign-BornPopulation.pdf.
Evolving Models Of Behavioral Health Integration In Primary Care
Mental illness has an impact on all age groups. While patients typically present with a physical health complaint, data suggest that underlying mental health or substance abuse issues often are triggering these visits. Unfortunately, most primary care doctors are ill-equipped or lack the time to address fully the wide range of psychosocial issues presented by patients. Improving the screening and treatment of mental health and substance abuse problems in primary care settings and improving the medical care of individuals with serious mental health problems and substance abuse in behavioral health settings are two growing areas of practice and study. Generally, this combination of care is called integration or collaboration. A report from the Milbank Memorial Fund provides an orientation to the field.
The report can be accessed by clicking http://www.milbank.org/reports/10430EvolvingCare/10430EvolvingCare.html.
Academic Medicine Collection Highlights Comparative Effectiveness Research
While comparative effectiveness research (CER) is important to clinical investigators, its scope also extends to areas of research and education focused on health care delivery improvements. A collection of articles in the recently released June 2011 issue of the journal Academic Medicine examines CER and its growing effect on academic health centers as it becomes an increasingly critical topic in discussions about the implementation of health care reform.